Medical Billing Specialist
Integrated Medical Services (IMS) is a physician-led organization united through its providers’ commitment to high-quality, innovative health care. This multi-specialty group has primary care and most specialties well represented throughout the Phoenix metropolitan area and many rural locations.
IMS is looking for a talented Billing Specialist to join our team!
The position will be responsible to process and submit accurate and timely claims to payers, analyze and research unpaid claims and assist in the resolutions of denial, partial payments and payment variances. The position will work with the manager and clinic leadership to ensure assigned accounts are paid in a timely manner.
Essential Job Functions:
- Assists in the daily activities of the Business Office including basic coding, data entry, patient registration and claim review in an effort to resolve all patient inquiries and/ or disputes
- Works with the revenue cycle manager and director to monitor performance to team and employee KPI’s
- Collaborates with clinic leadership/staff to obtain needed information for processing claims
- Responsible for the processing of medical claim insurance payments, patient payments (including setting up payment plans), and applying insurance adjustments through data-entry in the EHR.
- Responsible for managing the use of adjustment codes, contractual adjustment codes, non-contractual adjustments codes, and bad debt codes.
- Responsible for managing low reimbursements and denials to determine when a reimbursement requires appeal.
- Responsible for assisting with billing secondary claims and EOBs that need follow up.
- Researches and processes insurance denials, unpaid claims or underpaid claims reviewing documentation and insurance/contract/coding guidelines. This process includes written appeals when appropriate and/or contacting the insurance. Additionally, inputs internal and external review decisions including charge adjustments, corrections, proper payment and re-submission of claims in the claims system.
- Responsible for reviewing and correcting claims that are suspended by the billing system. Assists in identifying accurate insurance. Updates/modifies insurance information with redirection of charges when appropriate.
- Comply with and adhere to all regulatory compliance areas, policies and procedures (including HIPAA and PCI compliance requirements)
- Provide excellent customer service to patients and clinic staff when answering CBO calls.
- Identifies, researches, and prepares refunds to patient and insurances.
- Supports and assists in the follow up and identification of billing issues for outstanding claims.
- Remains current on billing and coding procedures and changes.
Education, Certification and Licenses:
- High School diploma or GED required.
- CPC (coding) license preferred
- 3 years minimum experience required, specifically medical office/physician billing and insurance claim follow-up and denial management
- Knowledge of Athena system preferred
- Ability to speak Spanish, a plus.
Great compensation and benefits package to include, medical, dental, vision, company paid life insurance, long and short term disability, 401k and more!
*IMS is a tobacco free workplace.
IMS is an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, sex, disability status, sexual orientation, gender identity, age, protected veteran status or any other characteristic protected by law. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.
It is the policy of IMS to provide equal opportunity in employment. Selection and employment of applicants will be made on the basis of their qualifications without regard to race, color, religion, creed, national origin, age, disability, sexual orientation, marital status, veteran status or any other legally protected status.
Job Status: Full Time
Job Reference #: 18