Job Description

Responsible for submitting clean insurance claims to insurance carriers. Account Receivable (AR) follow up with insurance carriers and patients for proper and complete payment on patient accounts as well as providing outstanding customer service to our patients and their families. Ensuring patient account balances are true and accurate and confirming patients understand their account balance and financial responsibilities. Assist patients with arranging payment plans, when needed, in accordance to practice guidelines.

Duties and Responsibilities:

  • Prepares, Reviews and Submits clean insurance claims to various insurance companies either electronically or paper within the appropriate timely filing limits of each payor.
  • Available and able to answer billing account questions from patients, staff members, insurance companies and practice providers, in-person and telephonically, while providing outstanding customer service.
  • Identify, acknowledge and resolve patient account billing concerns, requests and complaints.
  • Evaluate patient financial status and establish, monitor and maintain monthly payment plans in accordance to OrthoArizona Mezona Orthopaedic practice guidelines.
  • Identifies, investigates and reviews all outstanding account receivable accounts to ensure prompt and proper payment.
  • Identifies, investigates, corrects errors and resolve issues on accounts to ensure proper payment from insurance carriers.
  • Performs various account collection activities, including, but not limited to, contacting patients telephonically, contacting payors, correction and resubmission of claims for reconsideration, filing appeals, etc.
  • Receive, process and post payments to accounts accurately and timely.
  • Prepare reports to identify, investigate and resolve A/R, referral, claim and account issues.
  • Monitor patient accounts for accurate billing information and change, correct and update accordingly.
  • Prepare and monitor patient billing statements.
  • Provide outstanding customer service, in-person and telephonically, to patients inquiring about their statements, account balances and financial obligations, responsibility and options for payment.
  • Submits accurate and appropriate account adjustments in adherence to practice protocols and policy.
  • Responds promptly and appropriately to all email and telephone messages.
  • Complete required monthly audits and maintain monthly goals as directed by the Billing Manager
  • Keeps the Billing Department Manager and Practice Administrator informed of all issues of concern related to patient account.
  • Other duties as assigned or are necessary to ensure the success of OrthoArizona Mezon. Orthopaedic.
  • Compliance with HIPAA, OSHA, Red Flag Rules, OrthoArizona and OrthoArizona Mezona Orthopaedic Policy and Procedures.
  • Participates in on-going educational activities including, but not limited to, department staff meetings, practice functions and outside programs.

Requirements Required:

  • High school diploma or GED certificate recipient with advanced knowledge of medical office billing
  • Minimum 3 years’ experience in medical billing, coding, collections and authorizations
  • Minimum 3 years’ experience of medical office billing computer programs and software
  • Minimum 1 year experience in the Arizona market
  • Advanced knowledge of CPT and ICD coding, billing and regulatory issues
  • Advanced knowledge of regulations regarding payers, including Managed Care, Medicare, AHCCCS, Workers Compensation, etc.
  • Good working knowledge of Human Anatomy and Physiology
  • Strong ethical and moral character references
  • Good computer skills.
  • Excellent communication skills with accuracy and diplomacy in discussing financial matters with patients
  • Outstanding Customer Service skills