Benefits:

401(k)

401(k) matching

Company parties

Competitive salary

Dental insurance

Employee discounts

Free food & snacks

Health insurance

Paid time off

Profit sharing

Training & development

About Us: Black Canyon Surgical Center is a multi-specialty outpatient facility, named one of the best ambulatory surgery centers in the nation by U.S. News and World Report in 2024. This achievement demonstrates our unwavering commitment to quality care and our desire to make a difference in the lives of our patients and staff. We foster a vibrant workplace culture, supporting a healthy work-life balance for our employees. NO NIGHTS, WEEKENDS, OR HOLIDAYS!!!

Benefits: Health insurance including medical, dental, and vision insurance, PTO, 7 paid holidays, bereavement leave, 401K, 401K company match up to 4%, HSA, group life, profit sharing, long-term disability insurance.

Description: Primary responsibility of the Medical Billing Specialist position is to ensure accurate and timely billing on patient accounts with insurance companies, including claim submission, re-billing, and follow up as needed. Requires accuracy, thoroughness, and a good understanding of insurance procedures for referrals, authorizations, copays, and deductibles, as well as, payer reimbursement guidelines, payer portals, and appeals processes. Work is multi-task based with heavy phone and/or online payer portal activity. Must be able to communicate effectively with insurance companies, patients, physicians, and co-workers.

Reports To: Business Office Manager Supervises: None

Qualifications: High school diploma, requires frequent and constant judgment for timely response to patient questions and concerns, requires language skills adequate for effective written and interpersonal communication in American English, requires visual and auditory acuity adequate for frequent use of computers and occasional use of other business office equipment, ability to sit for long periods and to perform desk and office activities.

Experience: Four years of medical facility or medical business office experience required, automated billing systems experience required, experience in customer relations preferred, experience in third party payer requirements preferred, training/experience in business office activities preferred

Job Knowledge: Strong understanding of commercial health insurance, federal, and state coverage; Understanding of medical terminology, claims processing guidelines, and federal insurance regulations required

Occupational Exposure:

Category III exposure to bloodborne pathogens and may encounter chemical hazards.

Duties:

Enters procedural codes for each patient in patient account.

Files insurance claims both primary and secondary according to Facility Billing Standards.

Monitors billing for accurate and timely completion.

Monitors accounts receivable to identify billing errors, coding errors, and timely rebilling.

Scrutinizes each insurance payment for accuracy and compliance with contract discount; Corresponds with insurance companies regarding any discrepancy in payments.

Maintains current information on correct and lawful practices in billing government and private payers for ambulatory surgical care.

Follows-up with third party payers and patients for services received in accordance to Facility Policy and Procedures.

Generates patient statements according to facility policy and procedures.

Answers patient and family member questions and refers questions to healthcare professionals when appropriate.

Communicates pertinent information from the physician staff, insurance companies and other significant parties to the patient.

Educates patients about Facility charges, insurance coverage and payment options.

At patient request, provides a written explanation of estimated fee schedules prior to surgery and documents it in the patient's medical record.

Accurately post patient and third-party payments to accounts.

Reports regularly to the Business Office Manager about the status of current projects or workflow.

Reports status of accounts receivable as requested.

Reconcile accounts receivable, generate and submit monthly reports to accountant on a monthly basis per protocol.

Greet patients, answer phones, take messages, return calls and provided needed information, while documenting all phone calls accurately and completely in the EMR.

Salary Range: $18.82-$27.00 Compensation for this role will depend on a number of factors, including candidate’s qualifications, skills, competencies and experience.