Specialist, Prebilling Lead

PHI Health•Phoenix, AZ

2d•Onsite

About The Position

PHI Health is seeking a Specialist, Prebilling Lead to join their team. As the leading air ambulance provider in the United States, PHI Health transports over 22,000 patients annually from more than 80 bases, committed to providing top-tier emergency medical services with unmatched speed and efficiency, and maintaining the highest standard of safety. The Specialist, Prebilling Lead will play a crucial leadership role in coordinating daily operations to ensure accurate and timely follow-up of outstanding medical claims prior to billing. This position acts as a Subject Matter Expert (SME) and the primary point of contact for escalated issues, process improvement, and staff support. Success in this role requires extensive knowledge of payer requirements, healthcare reimbursement practices, and a strong foundation in revenue cycle operations to enhance services and expand reach to those in need.

Requirements

High School Diploma or equivalent required
3+ years of experience in medical collections or healthcare revenue cycle management.
Strong understanding of commercial, Medicare, and Medicaid payer policies.
In-depth knowledge of healthcare billing systems and payer portals.
Familiarity with Medicare, Medicaid, and commercial payer guidelines.
Excellent problem-solving and critical thinking skills.
Strong analytical, organizational, and communication skills.
Ability to handle multiple tasks in a fast-paced environment.
Proficiency in Excel and other Microsoft Office tools.

Nice To Haves

Associate’s degree preferred.
1+ year in an SME, leadership or supervisory role preferred.

Responsibilities

Serve as a Subject Matter Expert for complex account resolution, claim escalations, payer communications, and departmental procedures.
Manage and resolve high-balance, aged, or escalated accounts, including advanced follow-up.
Assist in improving prebilling workflows and processes to increase efficiency and reduce claim cycle times.
Partner cross-functionally with billing, coding, and patient services teams to address denials, rejections, and underpayments.
Generate and evaluate daily and weekly unbilled reports to identify issues and recommend corrective action to management.
Stay up to date with current payer policies, medical billing guidelines, and industry regulations.
Support training initiatives by mentoring new hires and existing staff on best practices, system use, and policy updates.
Provide oversight of daily workflows, ensuring productivity standards are met within systems and among team members.
Conduct account audits and deliver feedback and corrective action as needed to ensure quality and compliance.
Review and approve timely filing actions, patient complaints.
Act as a liaison with outside collection agencies, partner facilities, and other providers to address inquiries or requests.
Demonstrate strong knowledge of insurance payers, including private, government, workers’ compensation, auto, and others.
Maintain a high level of professionalism and excellent communication skills, both written and verbal.
Exhibit strong organizational skills with the ability to multi-task and prioritize in a fast-paced environment.
Remain coachable and open to continuous improvement, process changes, and system updates.
Perform other duties as assigned to support departmental and organizational objectives.
Any other duties as assigned.
Supports company Safety Management System activities and Destination Zero, complying with HS&E policies.