Billing and Registration Specialist
Bayless Healthcare Group - Phoenix, AZ

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ESSENTIAL JOB FUNCTIONS:

  • Timely and accurate electronic 837P files and hard copy submissions of HCFA1500 claim both to primary and secondary payers.
  • Monitors, researches, and validates service data prior to billing
  • Timely and accurate loading of electronic and paper Explanation of Benefits and related reports to resolution
  • Resolving outstanding A/R balances per department guidelines
  • Identify trends / lack of payment issues with payers and escalate to supervisor any conflicts with payers towards resolution
  • Thorough understanding of RBHA and other payer billing requirements and procedures
  • Responsible for accurate record keeping of claims billing
  • Assists in maintaining procedure manuals
  • Assist with creating and generate reports as scheduled or when needed
  • Utilize the department team to discuss, enhance, and resolve issues
  • certified coder that ensures E & M codes are accurate on prescriber forms
  • Validate all client eligibility via AHCCCS, RBHA, Insurance companies, etc., confirming services requested are covered contractually.
  • Data entry/ enroll of client demographics and eligibility on a timely and accurate basis.
  • Pursue all needed authorizations for services requested on a timely and accurate basis.
  • Pursue all continuing authorization requirements on a timely and accurate basis.
  • Reconciling eligibility/insurance coverage discrepancies
  • Notify all appropriate staff to initiate services
  • Identifies and resolves problems with client eligibility/insurance coverage.
  • Assist with coordinating/scheduling facility “Clinics” for designated prescribers per established department guidelines
  • Assists in maintaining procedure manuals.
  • Assist with creating and generate reports as scheduled or when needed
  • Works closely with (title to be determined) in establishing timelines and priorities
  • Utilizes the department team to discuss, enhance, and resolve issues
  • Other duties and special projects as assigned

Communicates accurately, clearly, and professionally.

  • Communicates in a positive, respectful, and courteous manner.
  • Practices active listening skills and uses partnering communication strategies
  • Interacts with coworkers and the community to build productive and collaborative relationships to support the achievement of agency and program goals.
  • Understands and maintains private and sensitive information within the confines of need-to-know parameters.
  • Reviews email daily and uses various writing styles and formats to produce effective communication including a clear purpose and intent.
  • Maintains a calendar and uses calendaring to schedule appointments on a daily basis that is available for review.

Functions as an effective team member with co-workers and the community to build productive, collaborative relationships that support achievement of program goals and objectives.

  • Shares pertinent information with director, contractors, and team members regarding work progress, successes, barriers, concerns, and other areas that may have an impact on the department’s services or image, may affect relationships with key participating parties within the confines of need-to-know.
  • Attends and participates in staff meetings in accordance with department standards and schedule. Supports the decisions of the director and members of the management team to staff, participants, and the community.

Utilizes supervision effectively, takes initiative to secure professional development opportunities, and applies relevant information to the work setting.

  • Prepares and participates in supervision that is regular, reflective, and collaborative in nature.
  • Recognizes the personal limits of competencies and expertise, seeks supervision and guidance accordingly.
  • Maintains a reasonable level of awareness of current professional information in fields of activity and undertakes regular and ongoing efforts to maintain competence in the skills used.

EDUCATION, EXPERIENCE, AND OTHER QUALIFICATIONS:

1) High School Diploma or G.E.D., Associates degree preferred
2) Minimum 4 years medical billing experience, which includes at least 2 years of electronic claims submission. Primary care experience preferred
3) Certified coder with EHR systems experience preferred
4) Knowledge of HIPAA requirements related to medical records and billing requirements
5) Experience with a variety of contractual reimbursement arrangements,
6) Requires knowledge of healthcare billing practices including CPT-IV, ICD-9, and State AHCCCS codes using HCFA1500 requirements.
7) Must have experience with automated billing systems
8) Knowledge of mental health billing desired.
9) Microsoft Office experience which includes Word, Excel, Access and Outlook
10) Requires a great attention to detail
11) Requires excellent communication, problem solving, conflict resolution, ability to multi-task, and organizational skills

Compensation

  • Competitive salary, commensurate with experience
  • Benefits package available includes medical/dental, life/disability insurance, paid vacation and holidays

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