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Arizona Department of Economic Security Insurance Billing Representative in Flagstaff, Arizona

This job was posted by https://www.azjobconnection.gov : For more information, please see: https://www.azjobconnection.gov/jobs/6664066

Overview

Responsible for two aspects of billing, collection, credit, payments, and/or reconciliations. Billing responsibilities include manual re-bills as well as electronic submission to payers. Follow-up includes telephone calls to payers and/or patients, as well as accessing payer websites, and resolving complex accounts with minimal or no assistance necessary.

Responsibilities

Billing\ * Demonstrates knowledge of editing and submitting claims to insurance clearing house by electronic or paper submission.

* Demonstrates knowledge of when to send a claim to the auditor or coder for corrections.

* Reviews and make corrections to rejected claims and resubmits to payers.

* Open communication on Updates-CPT codes and ICD-10 codes, as needed. Works with Billing Manager to maximize revenue potential based for services and providers.

\ Claim follow up\ * Corrects, edits and manages denied claims through work queues, correspondence and emails: May consist of Invalid CPT, Invalid DX, Missing Modifier, Bill another Carrier, Invalid Eligibility, Authorization/Referral, Documentation Required or Other open tasks requiring intervention.

* Enters encounter notes, regarding rejections and follow up activities performed to enable others to review claim history on all encounters.

* Performs account adjustments or write-offs as needed in accordance with the Write-Off policy.

* Handles internal communications with the health centers related to insurance billing and collections.

* Requests medical records from health centers as requested by the contracted insurance plans.

* Corresponds with and assists vendors involved with patient accounts.

\ Compliance/Safety\ * Responsible for reporting any safety related incident in a timely fashion through the Midas/RDE tool; attends all safety related training programs; performs work in a safe manner; monitors work environment for possible safety issues and ensures others are also performing work in a safe manner.

* Maintains confidentiality of all department, patient, and billing matters.

* Completes all company mandatory modules and required job specific training in the specified time frame.

* Stays current and complies with state and federal regulations/statutes and company policies that impact the employees area of responsibility.

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