Medical Billing and Credentialing Services

Provide comprehensive medical billing, revenue cycle management (RCM), payer enrollment, and provider credentialing services to support the efficient and compliant operation of FAU Medical Group.
- Charge Capture and Coding Support shall:
• Review submitted charges for completeness and accuracy.
• Validate CPT, HCPCS, and ICD-10 coding consistency.
• Identify coding discrepancies and communicate findings to Client personnel.
• Recommend corrective actions to reduce claim denials.
- Claims Submission shall:
• Prepare and submit electronic claims to commercial, government, and managed care payers.
• Submit clean claims within established timelines.
- Accounts Receivable Management shall:
• Track outstanding claims.
• Perform follow-up with insurance carriers on unpaid or underpaid claims.
• Investigate and resolve claim denials.
• Appeal denied claims when appropriate.
• Maintain aging reports and collection metrics.
- Payment Posting shall:
• Post insurance payments, adjustments, and patient payments.
• Reconcile electronic remittance advice (ERA) files.
• Investigate payment variances.
• Maintain accurate financial records.
- Patient Billing shall:
• Generate and distribute patient statements.
• Manage payment plans as authorized by the Client.
• Respond to billing inquiries.
• Refer accounts for collections only with Client approval.