Pre-Billing & Financial Liaison - Billing Specialist Sr. - Phoenix, AZ - Sign on Bonus up to $7,500

JOB SUMMARY

• Acts as a patient advocate when discussing outstanding balances to include third party payer options and Medicaid qualification process.
• Analyze adverse billing, collections, and payer trends and report/present to management to include suggested solutions.
• Assist with oversight and coordinating with staff for processing outstanding demographics, unbilled claims and incomplete demographic records.
• Basic understanding of payer fee schedules and claim requirements to include facility contracts.
• Categorize and quantify payer billing issues for resolution reporting to management.
• Demonstrate ability to contact insurances and government agencies in order to obtain eligibility, to process authorizations or discuss benefits and billing requirements.
• Demonstrate and maintain consistent customer focus in the face of adversity and change both internally and externally.
• Demonstrate proficiency in GH Live, GE/Centricity and external software as required.
• Demonstrates time management skills to support uneven volumes and monthly close requirements.
• Demonstrates understanding of payer fee schedules, enrollment requirements along with PHI payer and facility contracts.
• Demonstrates understanding of insurance types, financial classes for support of compliant billing .
• Good working knowledge of HCPCS, CPT, ICD-9/ICD-10 codes, medical terminology and clinical documentation.
• 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 concerns.
• Identify appropriate contacts and develop/maintain a professional relationship with all facilities and first responders in order to obtain demographic information for billing.
• Identify clinical and dispatch document discrepancies per PHI policies in order to support compliant and accurate billing.
• May assist with special projects related to payer issues or overall collection shortfalls.
• Must demonstrate positive teaming, effective cooperation in all communication within established team and throughout the entire PFS department.
• Notify clinical and dispatch personnel of any document discrepancies per PHI policies in order to support compliant and accurate billing.
• Knowledge and ability to train in patient accounting functions, tools and processes applicable to medical billing and accounts receivable management.
• May assist with special projects related to payer issues or overall collection shortfalls.
• Monitor and track transports with incomplete demographics and/or documents to prioritize work throughout the team in order to maintain production standards.
• Must demonstrate positive team building skills, effective cooperation in all communication within established team and throughout the entire PFS department.
• Identify and notify clinical and dispatch personnel of any document discrepancies per PHI policies in order to support compliant and accurate billing.
• Organize work through assigned queues to ensure all transports are billed accurately in a timely manner.
• Participate in increasing responsibility through ongoing training and expansion of duties.
• Perform, identify, collect and confirm insurance coverage to include obtaining prior authorization, third party liability and coordinator of benefits.
• Performs in-depth account review for proper clinical charts, dispatch, facility for support of compliant billing.
• Performs in-depth account review for proper field requirements for support of compliant billing.
• Performs research for new payers and their compliant billing requirements.
• Proficiency in Microsoft windows, Excel, and word. Proven ability to manage files and use all web-based tools available. 
• Provide leadership and to act as a resource for management to assist, train and provide support to the PFS Billing Staff
• Represents PHI in a customer centered and compassionate manner when contacting patients and their families to obtain billing information.
• Understand billing requirements and system requirements to bill all insurances in support of clean claims – electronic or paper.
• Understand billing requirements for all payers and programs and participate in ensuring claims are accurate prior to submission.
• Research, evaluate and interpret and payer specific billing policies, guidelines and statutory regulations for insurance and collection follow-up.
• Supports and conducts training for PFS staff of new and established payers to include compliant billing requirements.
• Take direction, coordinate projects and prioritize assignments on individual basis, as well as on a departmental/team level.
• claims prior to submission for both electronic or paper claims
• Complying 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.

SCHEDULE/LOCATION

• 5 & 2
• Phoenix, AZ

QUALIFICATIONS/EXPERIENCE

• Must have completed high school diploma (or GED equivalent) and have 5 plus years of previous experience in medical billing/collections with a progressive increase in complexity and responsibilities.
• Must have knowledge of general office procedures using office equipment.
• Must have PC skills and demonstrated proficiency in Microsoft Office Word, Excel and medical billing software.
• Must have prior experience with email and using the web.
• Must be able to pass a pre-placement drug test and background screen.
• This position is designated Safety Sensitive for purposes of the Arizona Medical Marijuana Act.

SALARY

• Regular pay scale applies

CORE COMPETENCIES:

• Safe. We are absolute in our belief in the tenets of Destination Zero and that Zero is not only achievable, but the only acceptable outcome.
• Efficient. We are focused on outcomes that are smart and responsible by making the best use of our resources to maximize overall productivity and achieve sustainable profitability as a high performing organization. 
• Quality. We are committed to ensuring excellent organizational performance which produces sustainable and reliable outcomes.
• Service. We are dedicated to the service of our customers, our communities and each other.

BEHAVIORAL COMPETENCIES:

• Drive & Energy – The ability to maintain a fast pace and continue to produce during exhausting circumstances.
• Functional & Technical Expertise – Allows the individual to add organizational value through unique expertise and serve as a resource to the organization within his/her area of expertise
• High Standards – Sets the stage for continuous improvements, the adoption of best practices and ultimately influences organizational standards.
• Initiative – Takes a proactive approach and takes action without being prompted.
• Integrity – Acts ethically and honestly and applies those standards of behavior to daily work activities.