li>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.
Medical Billing Specialist
Please Note: This is an Evergreen Job Posting
This position is part of an ongoing recruitment effort to build a pipeline of qualified candidates for future vacancies.
The position supports the full claim lifecycle from account review, billing validation, claim generation, claim editing, electronic submission, payer rejection correction, rebilling, denial follow-up support, and coordination of information needed to secure appropriate reimbursement from third-party payers and responsible parties. Supports Altera Sunrise SCM/SFM billing workflows, including claim generation, account review, charge validation, billing work queues, payer/plan configuration concerns, account edits, and system-based claim troubleshooting, as applicable to assigned responsibilities.
Coppermine, Arizona13 days ago
The position supports the full claim lifecycle from account review, billing validation, claim generation, claim editing, electronic submission, payer rejection correction, rebilling, denial follow-up support, and coordination of information needed to secure appropriate reimbursement from third-party payers and responsible parties. Supports Altera Sunrise SCM/SFM billing workflows, including claim generation, account review, charge validation, billing work queues, payer/plan configuration concerns, account edits, and system-based claim troubleshooting, as applicable to assigned responsibilities.
Tuba City, AZ30+ days ago
Licensure/Certification: Must possess a valid, current, full and unrestricted license to practice as a nurse practitioner or physician assistant in any state within the United States, District of Columbia, or the Commonwealth of Puerto Rico. Ensure proper PPE is always worn while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield.
li>Successful completion of and positive results from all background and reference checks, including positive employment references from authorized representatives of past and current employers demonstrating to the satisfaction of TCRHCC a record of satisfactory performance and that the applicant can perform the essential functions of the job. Licensure/Certification:
- Must possess a valid, current, full and unrestricted license to practice as a nurse practitioner or Physician Assitant in any state within the United States, District of Columbia, or the Commonwealth of Puerto Rico.
li>Quantitative analysis - Performs a comprehensive review for the record to assure the presence of all component parts such as: patient and record identification, signatures and dates where required, and other necessary data in the presence of all reports which appear to be indicated by the nature of the treatment rendered. Advance knowledge of medical terminology, abbreviations, techniques and surgical procedures; anatomy and physiology; major disease processes; pharmacology; and the metric system to identify specific clinical findings, to support existing diagnoses, or substantiate listing additional diagnoses in the medical record.
Coppermine, Arizona16 days ago
li style="margin-left:0.25in">Quantitative analysis – Performs a comprehensive review for the record to assure the presence of all component parts such as: patient and record identification, signatures and dates where required, and other necessary data in the presence of all reports which appear to be indicated by the nature of the treatment rendered. Advance knowledge of medical terminology, abbreviations, techniques and surgical procedures; anatomy and physiology; major disease processes; pharmacology; and the metric system to identify specific clinical findings, to support existing diagnoses, or substantiate listing additional diagnoses in the medical record.
Tuba City, Arizona15 days ago
li style="margin-left:0.25in">Ensure proper PPE is always worn while on duty including but not limited to, face mask, gloves, gown, isolation gown, NIOSH-approved N95 filtering facepiece respirator or higher, if available), and eye or face shield. Provides health care and preventive services to healthy individuals including immunizations, guidance in nutrition, common illnesses, accidents, child growth and development, substance abuse, exercise, and depression screening.
Benefits packages, including medical, dental, STD, LTD, Life, and other voluntary benefit offerings (for employees working 30+ hours per week). Advanced Dermatology and Cosmetic Surgery's mission is to deliver the highest quality patient care and experience in dermatology and aesthetic services.
Phoenix, Arizona30+ days ago
This role partners closely with value-based care managers, operational leaders, network managers, and market clinicians to develop and execute clinical strategies that improve quality, outcomes, patient experience, and MSK total cost of care. - Medical Degree from accredited school as determined by either the Liaison Committee on Medical Education (LCME) or the American Osteopathic Association Commission on Osteopathic College Accreditation (COCA) AND must have graduated from an accredited graduate medical education program (residency) as determined by the Accreditation Council for Graduate Medical Education (ACGME) .
li>Excellent verbal communication skills as there are times you may need to have difficult conversations retraining office staff and going over what was done incorrectly and how things need to be completed moving forward (leadership experience, training experience or lead experience would be great for this). The Population Health Medical Assistant supports primary care teams within the network, either remotely or from a primary care office, to enhance compliance with population health initiatives such as annual wellness visits, quality care gap closure, and in-network referrals.
p>Located in the Mesa and East Valley region, this opportunity offers year-round sunshine, access to hiking and outdoor recreation, and proximity to the greater Phoenix metropolitan area. Whether you enjoy desert landscapes, mountain biking, golf, or vibrant city life nearby, this region offers flexibility and lifestyle balance.
p>The fraudulent LinkedIn messages and emails, which do not originate from any Executives LinkedIn account or of UnitedHealth Group's email domains, or those of any of its operating divisions, supposedly conducts an interview via a Zoom meeting, offers a work from home job at Optum, emails an application, sends a fake check by next day delivery through USPS and asks recipients to pay a vendor a large dollar amount. Primary Responsibilities:
- Assist in the care of patients through telephonic outreach to identify care needs and barriers to care, connect patients to community resources, and schedule hospital follow up appointments, screenings and Annual Wellness Visits including recently discharged patients.
Scribes receive extensive on-the-job training in clinical workflows, value-based medicine, preventative care for chronic conditions, accurate and specific documentation, population health data streams, and team based care. This is an excellent opportunity for pre-med track individuals looking to gain practical, paid experience in a clinical setting before applying to an MD/DO/PA/NP program, as well as those pursuing careers in Health Informatics, Public Health, Healthcare Administration, Medical Coding, and other related fields.
Scribes receive extensive on-the-job training in clinical workflows, value-based medicine, preventative care for chronic conditions, accurate and specific documentation, population health data streams, and team based care. This is an excellent opportunity for pre-med track individuals looking to gain practical, paid experience in a clinical setting before applying to an MD/DO/PA/NP program, as well as those pursuing careers in Health Informatics, Public Health, Healthcare Administration, Medical Coding, and other related fields.
Scribes receive extensive on-the-job training in clinical workflows, value-based medicine, preventative care for chronic conditions, accurate and specific documentation, population health data streams, and team based care. This is an excellent opportunity for pre-med track individuals looking to gain practical, paid experience in a clinical setting before applying to an MD/DO/PA/NP program, as well as those pursuing careers in Health Informatics, Public Health, Healthcare Administration, Medical Coding, and other related fields.
Scribes receive extensive on-the-job training in clinical workflows, value-based medicine, preventative care for chronic conditions, accurate and specific documentation, population health data streams, and team based care. This is an excellent opportunity for pre-med track individuals looking to gain practical, paid experience in a clinical setting before applying to an MD/DO/PA/NP program, as well as those pursuing careers in Health Informatics, Public Health, Healthcare Administration, Medical Coding, and other related fields.