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Logistics Support

Stamford Hospital

Logistics Support

Phoenix, AZ
Full Time
Paid
  • Responsibilities

    JOB SUMMARY:

    The Revenue Cycle Specialist - Denials is responsible for researching, resolving, and resubmitting denied claims; taking timely and routine action to collect unpaid claims; and interpreting various forms of explanations of benefits (EOBs) from insurance carriers

     

    MAJOR ACCOUNTABILITIES/CRITICAL RESPONSIBILITIES:

    • Understands and interprets insurance Explanations of Benefits (EOBs), knowing when and how to ensure that maximum payment has been received.
    • Researches and resolves rejected, incorrectly paid, and denied claims within an established time frame.
    • Researches and resolves unpaid accounts receivable and makes any corrections in medical group’s practice management system necessary to ensure maximum reimbursement for all services rendered.
    • Resubmits claim forms as appropriate.
    • Professionally responds to all billing-related inquiries from patients, staff, and payers in a timely manner.
    • Utilizes available resources to identify reasons for payment discrepancies.
    • Keeps management informed of changes in billing requirements and rejection or denial codes as they pertain to claim processing and coding.
    • Accurately documents patient accounts of all actions taken.
    • Communicates with clinic management and staff regarding insurance carrier contractual and regulatory requirements.
    • Educates clinic management and staff regarding changes to insurance and regulatory requirements.
    • Actively participates in practice management and payer meetings.

    Required Skills Required Experience

    • Associate’s degree or medical billing certification preferred. CPC preferred.
    • 3+ years of experience working in a multispecialty group practice, healthcare system with an ambulatory focus, or academic medical center.
    • 3+ years of experience working with a medical office/hospital accounts receivable system.
    • Extensive knowledge of insurance payer reimbursement, collection practices, and accounts receivable follow-up.
  • Qualifications

     Through previous background and experience, the candidate must be able to demonstrate, with or without an accommodation:

    • Knowledge of branch product lines.

    • Knowledge of shipping and receiving practices.

    • Knowledge of Company policies and procedures.

    • Skill in organizing and prioritizing personnel and work activities.

    • Knowledge of merchandise handling and production methods.

    • Some knowledge of basic math skills such as adding, subtracting, multiplying, and dividing.

    • Ability to effectively communicate.

    • Must be a team player and abide by IES’s strong core values and beliefs.

  • Industry
    Hospital and Health Care