Full Cycle Medical Billing

Job Description

Job Description

Full Cycle Medical Billing
Job Details Job Location: AUUA Glendale - Glendale, AZ
Position Type: Full Time
Job Shift: Day

Charge Entry Portion:

• Post charges daily

• Reviews charges for correct coding

• Audit codes for potential missed charges

• Preparing, reviewing, and transmitting claims using billing EMR

• Reconcile missing encounters

Prior Auth Portion:

• Review EMR chart messaging and review schedules daily for upcoming surgical & in office procedures

• Review chart documentations to ensure patient meets medical policy guidelines

• Prioritize authorization request according to urgency

• Obtain authorization via payer website or by phone and follow up regularly on pending cases

• Verify coverage and benefits and calculated any out-of-pocket portions due

• Contact patients to review any out-of-pocket portions due prior to surgery

AR Follow Up Portion:

-Resolve errors and make claim edits assigned in work buckets

-Follow work list prioritization of accounts as established by department policies and procedures for resolving accounts and/or submitting claims

-Contact payers and patients when necessary

-Request relevant information from appropriate Revenue Cycle and clinical departments as required through the course of the PFS Processes

-Make necessary adjustments to patient demographic, insurance, and account balance information

-Complete A/R adjustments where permitted and appropriate: request other adjustments were permitted and appropriate

-Comply with and adhere to all regulatory compliance areas, policies and procedures (including HIPAA and PCI compliance requirements) , and “leading practices

Requirements

• Minimum 1 year charge posting, prior authorization and AR follow up experience

• Understanding of payer medical policy guidelines to manage authorizations effectively

• Proficient use of CPT and ICD10 codes

• Detail oriented and above average organizational skills

• Plans and prioritizes to meet deadlines

• Ability to multitask and remain focused while managing a high volume, time sensitive workload

• Interventional Radiology (IR) experience helpful

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