Primary City/State:
Virtual Arizona
Category:
Billing and Revenue Cycle
Shift:
Day
Department:
Patient Financial Services
Experience working with Aetna Commercial or other commercial payers.
Great care starts with great people. (Like you.)
At HonorHealth, you’ll find something special. From humble beginnings in 1927 to one of Arizona’s largest nonprofit healthcare systems, our culture is built on warmth and neighborly kindness. Behind every smile is a highly skilled professional with deep expertise and an unwavering dedication to what matters most — caring for the health and well-being of people and communities across the greater Phoenix area.
Responsibilities:
Job SummaryThis position performs collecting, reconciliation, credit balance resolution, research, correspondence and independent problem solving. Reconciles complex, multi-payment accounts. Submits appeal letters on underpaid claims as directed. Interprets payer contracts to determine if payment and PCON adjustment is accurate. Reviews EOB's for denials, along with posting corrected adjustments in order to balance accounts. Identifies needs for process improvements and creating/enhancing processes in the PFS department. Promotes positive teamwork within department and among employees. Works with all hospital departments for proper coding and billing procedures. Follows all departmental, hospital, and regulatory policies and procedures, including HIPAA requirements. Utilizes top customer service skills with all customers: patients, government agencies, commercial insurances, other hospital departments, physicians' offices and attorneys' offices.
Essential Functions- Reconciles accounts on a daily basis to determine underpayment, overpayment or contractual adjustment correction. Utilizes technical ability and understanding of applicable insurance contracts and regulations.
- Maintains current knowledge of regulatory billing requirements for specified payors. Attends in-services/continued education
- Interprets data processing reports and applies the information as needed for daily departmental productivity.
- Trains other staff members on reconciliation techniques and other aspects of the position.
Education- Other Post high school education, to include, but not limited to accounting courses or medical business office certificate program - Preferred
- High School Diploma or GED - Required
Experience- 5 years Billing or collections - Preferred
- Other 18 months patient accounts experience - Required
- Other 18 months billing, collection or Medicare/Commercial billings - Required
Licenses and Certifications
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