Job Description

Job Description

Job Description

Description:

ABOUT US

For over 55 years, we have been recognized as a global innovator in advancing care for foot and ankle conditions, sports medicine, and related clinical programs. Our mission is to enhance quality of life by delivering the most advanced, patient-centered foot and ankle care. At WFAI, we’ve experienced remarkable growth and remain committed to a future guided by that same momentum. As our organization continues to expand, we remain grounded in our core values: integrity, excellence, trust, compassion, tradition, and innovation.

Position Summary:

We have an immediate need to hire an experienced Insurance collector who will be responsible for reviewing claims activity for billing and submitting claims in the revenue cycle billing and claims functions. Including responsibility for billing, submission, and resolving billing from the clinics, surgery centers, and hospitals related to the company. The individual will need to identify, and present process improvement recommendations based on gathered knowledge and experience while working directly with the providers’ documentation and productivity. Determine and assess patient records, review accounts receivable activities, and collect payments. This position is responsible for effectively communicating with clinicians on a regular basis.

Key Responsibilities:

• Review and appeal unpaid and denied claims based on standard appeal processes as governed by the payor
• Determine accuracy of Insurance Payments and follow up on discrepancies.
• Run and build reports as required and/or requested.
• Experience with high volume, strategic management of A/R
• Respond to patient and/or insurance companies billing questions in a timely manner.
• Perform miscellaneous job-related duties as may be assigned.
• Execute work on assigned claim worklists, AR worklists, reporting, or projects.
• Communicates trends and root issues through proper lines of reporting.
• Provides support to medical providers and practice specialists as appropriate regarding coding compliance documentation.
• Meets productivity and Key Performance (‘KPI’) Indicator standards.
• Must demonstrate highly ethical behavior and good judgment including the ability to always maintain the utmost confidentiality appropriate within a medical work environment.

QUALIFICATIONS:

Required: To perform this job successfully, an individual must be able to perform each essential function satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or abilities.

• Minimum of 3 years’ experience interpreting insurance explanation of benefits, with minimum of 3 years’ experience with medical claims, billing, payment posting and insurance collections with a high school diploma or equivalent.
• Active Certified Professional Coder (CPC) required.
• Ability to use independent judgment and to manage and impart confidential information appropriately.
• Knowledge of legal, regulatory, and policy compliance issues related to medical coding and billing procedures and documentation.
• Knowledge of all Insurance guidelines especially Medicare and Medicaid according to standards.
• Ability to effectively communicate logically and clearly both verbally and in writing.
• Respectfully accepts coaching and guidance understanding it is intended to impart knowledge and help with success in the role.
• Understands office gossip is frowned upon and consciously does not participate.
• PC Proficient with good working knowledge of Microsoft Office, including Word, Excel, and Outlook, database systems and report generation.
• Ability to occasionally travel to hospitals / clinics.
• Able to provide proof of legal eligibility to work in the United States without sponsorship.
• Ability to successfully pass an in-depth background investigation and DMV report.

Desired:

• Ancillary billing experience is preferred.

BENEFITS:

• Competitive hourly pay rate depends on experience level.
• Medical
• Dental
• Vision
• Life Insurance
• Flexible Spending Account
• Healthcare Spending Account
• 401(k) Matching
• Paid Time Off
• Training Provided
• Pet Insurance
• Remote work

PHYSICAL DEMANDS:

• Physical demands to successfully perform the essential functions of this job including but are not limited to walking, sitting, stooping, kneeling, standing, and crouching
• The employee must be able to regularly lift up to 10 pounds
• No specific vision requirements
• No specific noise requirements

AMERICAN WITH DISABILITIES ACT (ADA) SPECIFICATIONS:

Qualified individuals with disabilities may request reasonable accommodation to the Director of Human Resources. Upon receipt of an accommodation request, the Director of Human Resources will meet with the requesting individual to discuss and identify the precise limitations resulting from the disability and the potential accommodation that might help overcome those limitations. The Director of Human Resources in conjunction with a medical review (and, if necessary, other appropriate management representatives) will determine the feasibility of the requested accommodation and the impact on the business operation. The Director of Human Resources will inform the qualified individual of the decision about the accommodation request or how to make the accommodation. This role is open to candidates in Alabama, Illinois, Indiana, Kentucky, Louisiana, Michigan, Mississippi, North Carolina, New Mexico, Ohio, Virginia, Tennessee, Texas, Virginia, and Wisconsin.

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