NCG Medical is a profitable and growing Revenue Cycle Management firm based outside of Orlando, FL. Our company has over 40 years of a successful track record of developing solutions for private practice physicians. We are continuing to grow and are excited to welcome several new client accounts and are adding to our team.
Responsibilities:
- Ability to work in a fast paced environment, work daily aging reports and follow up on high-volume insurance claims.
- Analyze and resolve EDI claim rejections and batch denials.
- Interpret and act on Explanation of Benefits (EOBs) and insurance payment details.
- Ability to file initial and secondary appeals, including second-level appeals.
- Monitor and identify trends in claim rejections and denials; clearly communicate findings to management and suggest resolutions.
- Ensure daily submission of insurance claims and resubmission of corrected claims.
- Utilize knowledge of ICD-10, CPT, and HCPCS coding, including ICD-10 to CPT code mapping.
- Reference and apply LCD (Local Coverage Determinations) and NCD (National Coverage Determinations) appropriately to ensure coverage compliance.
- Maintain documentation and professional communication with providers regarding claim status and insurance requirements.
- Collaborate with team members while also operating independently with minimal supervision.
- Independently research claims, identify issues, determine next steps, and follow through to resolution
- Understand and identify benefits, network status, authorization requirements, exclusions, and payer policies
Requirements:
- Extensive knowledge of the medical revenue cycle and its impact on financial performance.
- Strong understanding of medical coding, billing, and reimbursement processes.
- Demonstrated experience working with EDI clearinghouses and insurance portals.
- Must be proficient in Microsoft Excel and Word.
- Strong analytical and problem-solving skills, with the ability to think creatively to resolve claim issues
- Excellent attention to detail, strong organizational skills and proven reliability. .
- Excellent communications skills both written and verbal.
- Must demonstrate the ability to thrive in a fast paced, high volume environment while maintaining accuracy and professionalism.
- Team-oriented with a strong work ethic and dependable performance.
- Must demonstrate reliability and dependability in all aspects of the position.
This position is a contract role with the opportunity to become permanent.
Monday - Friday with hours of 8:30am - 5:30pm
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