Follow Up & Collections - Billing Specialist IV - Non NSA

About the role

PHI Health is seeking a dynamic and driven individual 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. You will play a crucial role in orchestrating the seamless operations that keep our advanced fleet soaring and our patients safe.

Responsibilities

• Acts as a patient advocate to obtain additional information and support for claims processing or to discuss outstanding patient balance with options available for balance resolution.
• Analyze adverse billing, collections, and payer trends and report/present to management to include suggested solutions.
• Aid in special projects related to payer issues or overall collections shortfalls.
• Contact insurances in an assertive, consistent and knowledgeable manner in order to obtain timely payments.
• Draft correspondence to patients and payers including 1st level appeals for technical denials, and identify accounts to refer to Appeals Department for escalation.
• 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 complaints.
• Maintain a professional relationship and effectively communicate with first responders, facilities, PHI agencies, entities, insurers, attorneys and patient's.
• Support the team by researching, evaluating and communicating to the team, payer specific billing policies, guidelines and statutory regulations for insurance and collection follow-up.
• Respond, monitor and track claims and correspondence and prioritize work accordingly to maintain and meet productions standards.
• Review and interpret explanation of benefits to determine contractual compliance, accuracy of payment received, true patient responsibility, status of denied or reduction of service coverage and follow up appropriately.
• Understand billing requirements for all payers and participate in ensuring claims are accurate prior to submission; train staff on billing requirements for new and established payers.
• Understand insurance regulations and guidelines to include CMS guidelines in order to effectively discuss outstanding claims with payers related to slow payments, underpayments, denials and to ensure claims are processed compliantly and paid appropriately.

Qualifications

• Completed high school diploma (or GED equivalent) and have previous experience in medical billing/collections with a progressive increase in complexity and responsibilities.
• Knowledge of general office procedures using office equipment.
• Demonstrated proficiency in Microsoft Office Word, Excel and medical billing software.
• Prior experience with email and using the web.
• Some college preferred.
• Ability to pass a pre-placement drug test and background screen.

Skills

• Good working knowledge of HCPCS, CPT, ICD-9, ICD10 codes, medical terminology and clinical documentation.
• Understanding of billing requirements for all payers and participation in ensuring claims are accurate prior to submission.
• Knowledge of insurance regulations and guidelines to include CMS guidelines.
• Ability to communicate with insurances in an assertive, consistent and knowledgeable manner.
• Ability to handle patient calls in support of collections activities.
• Ability to perform in-depth account review such as skip tracing, correspondence research, secondary claims billing, payment review, contractual adjustments and modify insurances/demographic information.
• Ability to understand and provide visible support of Destination Zero.

Benefits

Our compensation and benefits package includes a regular pay scale and a sign-on bonus up to $7,500.

Pay

Regular pay scale applies.

Schedule/Location

Phoenix, AZ5 & 2

The Successful Candidate Will Have

• Completed high school diploma (or GED equivalent) and have previous experience in medical billing/collections with a progressive increase in complexity and responsibilities.
• Knowledge of general office procedures using office equipment.
• Demonstrated proficiency in Microsoft Office Word, Excel and medical billing software.
• Prior experience with email and using the web.
• Some college preferred.
• Ability to pass a pre-placement drug test and background screen.

Compensation And Benefits

Regular pay scale applies. Our Core Competencies include Safe, Efficient, Quality, Service, Drive & Energy, Functional & Technical Expertise, High Standards, and Initiative. The PHI Health Advantage includes outfitting each aircraft with the most advanced technology, rigorous protocols and training, and pioneering the most-forward thinking safety program in the country. The company has a well below the national average accident rate and was the first to receive the Vision Zero Aviation Safety Award.

Disclaimer

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed, as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. PHI, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.