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Billing Specialist - Follow Up & Collections IV A/R

Posted: October 24, 2023
Salary:US$18 - US$25.00 per hour + Dental, Vision, Healthcare, & PTO
Job type: Permanent
Discipline:Revenue Cycle
Work Location:On-site

Job description

Medix Healthcare:

Medical Billing & Follow Up Representative


M-F 8AM-4:30PM

Phoenix, AZ (Fully Onsite)




  • Acts as a patient advocate to obtain additional information and support for claims processing or to discuss outstanding patient balance with options available for balance resolution
  • Analyze adverse billing, collections, and payer trends and report/present to management to include suggested solutions
  • Assist with special projects related to payer issues or overall collections shortfalls
  • Contact insurances in an assertive, consistent and knowledgeable manner in order to obtain timely payments. This includes escalation of issue to supervisors and/or grievance departments
  • Demonstrate and maintain consistent customer focus in the face of adversity and change both internally and externally
  • Demonstrates understanding of payer fee schedules, enrollment requirements along with payer and facility contracts
  • Demonstrates, performs an understanding of insurance collections to include; payment in full (negotiation) offers, over payment reviews and approvals, next action on correspondence, insurance types, insurance classes,
  • Draft correspondence to patients and payers including 1st level appeals for technical denials, and identify accounts to refer to Appeals Department for escalation
  • Handle patient calls in support of collections activities to include financial review for charity program, payment plans, negotiation of discounts and proper resolution of patient complaints
  • Maintaining a professional relationship and effectively communicating with first responders, facilities, agencies, entities, insurers, attorneys and patients.
  • Must demonstrate positive teaming, effective cooperation in all communication within established team and throughout the entire PFS department
  • Participate in increasing responsibility through ongoing training and expansion of duties and procedures for appropriate next required action
  • Perform in-depth account review such as; skip tracing, correspondence research, secondary claims billing, payment review, contractual adjustments and modify insurances/demographic information
  • Perform, identify, collect and confirm insurance coverage to include obtaining prior authorization, third party liability and coordinator of benefits
  • Possess a good working knowledge of HCPCS, CPT, ICD-9, ICD10 codes, medical terminology and clinical documentation
  • Provide leadership and act as a resource for management to assist, train and provide support to the PFS Billing Staff
  • Research, evaluate and communicate to the team, payer specific billing policies, guidelines and statutory regulations for insurance and collection follow-up
  • Respond, monitor and track claims and correspondence and prioritize work accordingly to maintain and meet productions standards
  • Review and evaluate any patient account for appropriate handling - regardless of age, status or payer
  • Review and interpret explanation of benefits to determine contractual compliance, accuracy of payment received, true patient responsibility, status of denied or reduction of service coverage and follow up appropriately
  • Take direction, coordinate projects and prioritize assignments on individual basis, as well as on a departmental/team level
  • Understand billing requirements for all payers and participate in ensuring claims are accurate prior to submission; train staff on billing requirements for new and established payers
  • Understand insurance regulations and guidelines to include CMS guidelines in order to effectively discuss outstanding claims with payers related to slow payments, underpayments, denials and to ensure claims are processed compliantly and paid appropriately
  • Comply with Company HS&E policy and procedures
  • Responsible for supporting company Safety Management Systems activities
  • Understand and provide visible support of Destination Zero
  • Other duties and responsibilities as assigned

Pay Range: $18-$25/HR

Schedule: Monday through Friday, 8:00 am - 4:30 pm

Location: Phoenix, AZ

Selling Points

  • Sign-on Bonus of $7500
  • Paid out at time of becoming a FTE. (2 Year Working Period Required Or Ordered To Pay Back)
  • Bonus Structure for Productivity
  • Payouts: Up to 3% of annual rate of pay for team's cash collection goals being met and up to 2% of annual rate of pay for productivity goals
  • Free lunch every day.
  • Great Working Environment & Room For Advancement

Interview Process: One Virtual Or Onsite Interview

3-5 Must Have Skills/Qualifications

  • Ambulatory billing is highly preferred but candidates with 5 years of revenue cycle experience will be considered if they present extremely well.
  • 3-5 Years Of Medical AR Experience Minimum
  • Detailed knowledge and ability to understand payer regulations and
  • Billing/Revenue Cycle knowledge required.
  • Advanced Excel knowledge required.
  • Excellent work habits, including a willingness to work the hours
    necessary to get the job done.
  • This position is designated Safety Sensitive for purposes of the Arizona Medical Marijuana Act.

Nice to Have Skills:

  • Bilingual
  • Associates Or Bachelors Degree
  • GE Centricity EMR Experience
  • NextGen EMR Experience

Soft Skill/Attribute Requirements

  • Ability to work under pressure
  • Time Management
  • Pays Close Attention To Detail
  • Positive Attitude
  • Eagerness To Learn/Grow