Overview

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FirstHealth of the Carolinas is a nationally recognized health care system in central North Carolina with headquarters in Pinehurst, N.C. FirstHealth of the Carolinas has been nationally recognized as a top 150 place to work in health care by Becker's Healthcare for two consecutive years. We offer a competitive benefits package including membership to our fitness centers.

The Patient Billing/Follow-Up Collector/Coordinator at Moore Regional Hospital is responsible for managing the billing and follow-up process for patient accounts. This role involves correcting claim errors, processing insurance claims, ensuring compliance with federal and state regulations, and collaborating with other departments to secure payment. The position requires attention to detail, strong communication skills, and a thorough understanding of medical billing and insurance practices.

Responsibilities

Claim Management:

Correct internal and external claim errors/edits efficiently and timely.

Process all assigned insurance claims daily in compliance with regulations.

Understand and apply OCE and NCCI edits.

Assertively follow-up on phone calls with insurance carriers regarding payments.

Resolve technical billing denials and refer other denials to appropriate staff.

Work correspondence daily and handle refunds to insurance carriers.

Collaboration:

Communicate effectively with physician offices, insurance companies, and other departments.

Coordinate with other departments to correct information promptly.

Share and disseminate updates/revisions of billing claims information and regulations.

Documentation and Reporting:

Maintain accurate and correct documentation on claims.

Create and manage spreadsheets in Microsoft Excel.

Enter documentation on Medicaid, Financial Assistance, and other programs for staff awareness.

Compliance and Safety:

Use appropriate safety and infection control measures.

Promote public and employee safety.

Ensure claims are billed compliantly by staying updated with payer information.

Additional Responsibilities:

Correct claims through EPIC, FISS, and WEBTOOLs as needed.

Resolve technical denials daily and process adjusted and recouped claims.

Review and take action on referrals and emails daily.

Perform other tasks as assigned by the supervisor.

Qualifications

Education and Experience:

High school graduate.

Preferred: Two years of college or technical school, and two years of experience in a medical-related field.

Skills:

Proficient in computer skills and Microsoft Office Excel or equivalent software.

Knowledge of health/medical insurance and medical terminology.

Experience with email and calendar software.

Attention to detail and ability to prioritize tasks.

Working Conditions:

Office environment.

Physical Requirements:

Mobility and dexterity in working with hands and arms.

Age Groups Served:

Middle Adult

Older Adult

Young Adult

FirstHealth values diversity, equity, and inclusion, and works to create a culture of excellence in which all team members feel valued, connected, treated fairly and safe, and where differences are both respected and supported.