We are looking for a candidate with Pediatric Medical Billing experience to become a staff member, for our practice in south central Phoenix.
Duties include, but are not limited to:
- Oversee daily processing and submission of claims from practice management (PM) system to the clearinghouse and third-party payors.
- Our EMR is EClinical Works
- Continuously working the A/R and denials to prevent losses from timely filing and research denials to keep us informed accordingly.
- Proactively monitor for errors and issues and promptly resolve them to ensure payments are processed as not to exceed the timely filing rules.
- Resolve edits related to coding; obtain and review relevant documentation and ensure documentation supports services billed.
- Oversee the insurance correspondences, such Explanation of Benefits (EOB) and Coordination of benefits and researches appropriate claims steps, such as first or second appeal.
- Communicates with insurance carriers to track and check status of appeals.
- Work with insurance payors to ensure timely and accurate payments.
- Troubleshoot patient account issues, including direct resolution of billing issue with patients.
- Ensure accurate patient statements are sent out monthly along with analyzing patients accounts and recommend to collections accordingly.
- Ensure credentialing and privileging is accurately maintained with all payors and facilities, including the re-credentialing cycle.
- Perform other duties as may be assigned.
- This position is a full time, benefited position. Punctuality and forward thinking are a must.
Job Type: Full-time
• Pediatric: 1 year (Preferred)
• Medical Billing: 2 years (Preferred)
• High school or equivalent (Required)
• One location