Full Cycle Biller

SPOONERScottsdale, AZ
$19 - $21Onsite

About The Position

At Spooner, Arizona's largest physical therapy private practice, we are most proud of our culture of excellence that is founded on our core values. Spooner has been helping our communities achieve health through movement for over 35 years, and we continue to grow every year. If you are looking to join a company where you can build a career, Spooner is the place for you! Are you an outgoing and engaging individual committed to delivering exceptional customer service? Are you a natural communicator who enjoys communicating with diverse people? We encourage you to apply if you are ready to be at the forefront of customer service excellence! As the Medical Billing and Collections Specialist, you will serve as the communications hub between the company, patients, referring providers and payers. You will be responsible for analyzing claim denials, billing/collecting payments, and reviewing patient statements for accuracy. This role is vital in ensuring our clients and stakeholders receive the best possible experience. This is a fully on-site, in-person role based in North Scottsdale. Remote or hybrid work is not available.

Requirements

  • Minimum high school diploma or GED
  • Minimum of 2-3 years experience working in a medical field
  • Medicaid Billing experience preferred
  • Excellent customer service and communication skills
  • Must sign up for ID.me within 30 days of hire

Responsibilities

  • Provide a communication hub to and from the company, patients, clinic teams, referring providers, clearing house, and payers regarding benefit eligibility, payments, and denials (including authorization guidelines).
  • Accurately verify benefits and eligibility to ensure that our patients can make informed decisions in regard to the cost associated with their healthcare plan, while documenting eligibility and benefits within our systems.
  • Successfully schedule our patients with the goal of exceeding their expectations timely, conveniently, and with the right provider or specialist.
  • Answer inbound calls in order of when they are received.
  • Create and maintain multiple scheduling logs such as daily call volume, unscheduled cases, call attempts completed, daily verification log, etc.
  • Obtain prior authorization for new patients/initial authorizations scheduled by Central Client Services.
  • Re-verification of benefits for all active Spooner patients on a standard schedule.
  • Run daily verification reports.
  • Process all charge entry and claims submission functions, including coding and managing rejections.
  • Review status of patient accounts to identify and resolve billing and processing problems in a timely manner.
  • Resolve edits related to coding; obtain and review relevant documentation and ensure documentation supports services billed.
  • Review patient statements for accuracy and completeness and obtain any missing information.
  • Review and analyzing claim denials in order to perform the appropriate resolution, rebilling, and/or appeals steps.
  • Receive insurance correspondences, such Explanation of Benefits (EOB) and research appropriate claims steps, such as first or second appeal.
  • Communicate daily with insurance carriers to track and check status of appeals.
  • Research reasons of denial from first appeal and incorporate more in-depth rebuttals for second appeals.
  • Prepare an analytical summary report identifying areas of concern by dollar amount, volume and new denials.
  • Resolve tasks assigned to you and to billing.

Benefits

  • Medical Coverage
  • Student loan repayment program
  • Proactive Health Management Plan
  • Dental, vision, life, and other voluntary insurances
  • Paid time off and holiday pay
  • Generous continuing education funds
  • 401(k) matching
  • Employee Assistance Program
  • Employee referral bonus
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