Claims Resolution Specialist I - Revenue Cycle Operations
- (23000205)
USFTGP Taleo Facility Profile:
University of South Florida Tampa General Physicians (USFTGP) was created through an advanced affiliation between The University of South Florida and Tampa General Hospital to provide advanced care to patients and their families throughout Florida. Specialties include cardiology, endocrinology, hepatology, organ transplantation, pediatrics, primary care, neurology, OBGYN, neurosurgery & orthopedics.
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This is an exciting time and an opportunity to be part of the region’s best and only academic medical center from the very beginning. The effort will serve our communities across all missions, including patient care, teaching, research, and community outreach.As part of the onboarding process, you will be subject to a drug screening and will likely fall under the covid vaccination mandate as well.Responsible for prompt and accurate follow-up of all unpaid claims. Reviews assigned accounts to determine appropriate action needed with regards to claim resolution, appeals and resubmissions. Works within the established guidelines of the department’s procedures, policies and goals. Conduct studies/special projects to resolve outstanding accounts receivable. Position is remote with some in person attendance required.
Must be fluent and able to conduct business in English which includes reading, writing and speaking. Educational Requirements: High School Education, Associates Degree Preferred Experience Requirements: Two-year’s experience in physician billing and collection experience required. Extensive knowledge of payer policies and guidelines, LCD/NCD guidelines, MUEs, as well as NCCI and McKesson coding edits. Extensive knowledge of Revenue Cycle processes, rejection codes, interpreting 837 and 835 submissions, and demonstrate the ability to identify opportunities to reduce denials and increase payment. Understanding of CPT and ICD-10 guidelines required. Business Skill Requirements: Strong analytical and intuitive skills, self-motivated with the ability to multi-task and remain organized. Microsoft Office experience primarily Excel is preferred. * Requirements reflect the minimum level necessary to be eligible for this position. Equivalent combinations of education and experience may be considered.
