Claims Processing Assistant Pulmonology

• Location: Jacksonville, FL
• Facility: Ascension St. Vincent's Riverside Dillon Building
• Schedule: Full-Time

Responsibilities

• Prepares insurance claims for submission to third party payers and/or responsible parties.
• Reviews claims for accuracy, including proper diagnosis and procedure codes.
• Reviews claim rejections and communicates with payers to resolve billing issues.
• Prepares and reviews routine billing reports. Recommends process improvements based on findings.
• Responds to complex telephone and written inquiries from patients and/or third party payers and physician practices.

Qualifications

Licensure / Certification / Registration

• Required Credential(s):
  • None Required.

Education

• High School diploma equivalency OR 1 year of applicable cumulative job specific experience required. *Note: Required professional licensure/certification can be used in lieu of education or experience, if applicable.

Additional Preferences

• 3 years of experience handling acute and provider-based hospital medical billing
• Proficient with 1500 and UB04 claim forms
• Comprehensive revenue cycle understanding, spanning front-end, mid-cycle, and back-end RCM denial management
• Strong technical background in charge entry, coverage verification, LOB guidelines, and authorization requirements