Job: MEDICAL BILLING

Advanced Reimbursement Management is a company that supports a culture of team work and collaboration and respects an individual's talents and diversity. Our culture and values helps us in attracting and retaining quality team members.

JOB SUMMARY:
This position is responsible for billing, re-billing, follow-up and/or grievance preparation of assigned AHCCCS, MediCal or other accounts. The Account Specialist serves as a liaison to other ARM team members, hospital, governmental agency and health plan staff to facilitate payment of accounts. This individual is an advocate for both patients and hospital clients by working to ensure that claims are paid correctly and hospitals receive the reimbursement to which they are entitled.


ESSENTIAL JOB DUTIES INCLUDE BUT NOT LIMITED TO:

-Research account information including items such as UB04, UB92, itemized billing statements, estimate of benefits, remittance advices and system notes to assess current status of claim.
-Determines appropriate expected payment based on federal and state regulations and client contracts.
-Documents expected payment with breakdown in client information system.
-Takes appropriate action with claim which may include initial billing, adjustments, rebilling an/or preparation for grievance
-Ensures that all required information is included and correct on all appropriate forms, documents and conversations related to claim.
-Follows up on claims to ensure payer received and claim was correctly processed for payment.
-Review remittance advices for accuracy of payments and takes appropriate action.
-Accurately and completely documents action taken with account and reasons for adjustments.
-Communicates effectively with multiple constituencies including governmental agency staff members, health plan staff members, hospital clinical and business office staff.

1. Three + years experience in a related field.
2. Experience in a health care setting, especially hospitals and hospital business office
experience is desirable.
3. Working knowledge of computer programs, i.e., Microsoft Excel®.
4. Excellent verbal and written communication skills are essential.
5. Strong organizational and coordination abilities are required.
6. Working knowledge of UB04 and CMS 1500