Medical Billing Specialist III - Pre-Billing

PHI - Quality Care Through Quality Jobs•Phoenix, AZ

1d•Onsite

About The Position

Specialist, Med Billing - PreBilling III Join Our Life-Saving Team and take advantage of a sign on bonus up to $7500 while it lasts! Are you ready to elevate your career to new heights? PHI Health is looking for dynamic, driven individuals to join our team. We are committed to providing top-tier emergency medical services with unmatched speed and efficiency, saving lives when every second counts. By supporting our mission from the ground, you will play a crucial role in orchestrating the seamless operations that keep our advanced fleet soaring and our patients safe. With PHI Health you’ll collaborate with the best minds in the industry, driving initiatives that enhance our services and expand our reach to those who need it most. If you're passionate about making a difference and thrive on challenges, PHI Health offers an extraordinary opportunity to impact lives and develop your professional career in a meaningful way. Who We Are: PHI Health is the leading air ambulance provider in the United States. With an unmatched safety record and the best aviation, medical and communication specialists in the field, we set the standard in the air medical industry. We transport more than 22,000 patients each year from our more than 80 bases across the country, all while offering services and outreach education to local communities and leading healthcare systems. Our mission is simple: move communities to health while maintaining the highest standard of safety, period. Job Summary: Under the direction and supervision of the Team Operational Coordinator, Patient Financial Services, this position performs transport review to verify all required fields are appropriate for billing. In addition, this position gathers all demographic and insurance information needed for billing and payments. Employees in this position are self-directed and self-motivated to provide oversight for ensuring all transports are reviewed, verified, and billed in a timely manner.)

Requirements

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.
This position is designated Safety Sensitive for purposes of the Arizona Medical Marijuana Act

Responsibilities

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.
Categorize and quantify payer billing issues for resolution reporting to management.
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 to obtain demographic information for 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 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 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.
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.
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.
Understand payer billing requirements and system requirements to bill all insurances in support of clean and accurate claims prior to submission for both electronic and 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.