Posting Note: Hospital Collections Specialist

Location: Fully Remote - Arizona Residents ONLY

Schedule: Monday–Friday
Flexible schedule between 6:00 AM – 5:00 PM
Core Required Hours - 8:30 AM – 2:30 PM
Weekly Requirement: Employees must complete 40 total hours weekly

Required Qualifications
Minimum 2 years of collections experience
Hospital/facility billing experience REQUIRED
AHCCCS experience REQUIRED
Medicare knowledge REQUIRED
Government payer experience strongly preferred
Strong understanding of denial management and appeals processes


Role Summary
We are seeking an experienced Hospital Collections Specialist to support hospital revenue cycle operations with a focus on:

Medicaid/AHCCCS collections
Insurance follow-up
Appeals processing
Denial management
Claims resolution and reimbursement recovery

Key Responsibilities
Contact insurance companies regarding unpaid or underpaid claims
Submit and manage claim appeals
Follow up on denied claims and resolve discrepancies
Ensure claims are processed accurately and reimbursed appropriately
Work managed care and government payer accounts efficiently

This position oversees the collection activity for an assigned segment of the Accounts Receivable and performs collection duties in accordance with established federal and state regulations.

• Performs account follow-up on outstanding insurance balances and takes the necessary action for account resolution in accordance with established federal and state regulations.
  
  Contacts all assigned accounts in the work queue daily and provide sound collection follow-up on outstanding insurance balances.
• Batches, compiles, submits appeals and monitor accounts for proper reimbursement.
  
  Responsible for achieving and maintaining accounts receivable days at the established goal.
• Establishes and maintains effective communication with employers, other healthcare providers, insurers, and patients/families to secure accurate and pertinent information to maximize reimbursement.
  
  Communicates with internal and external customers by telephone and mail to verify charge accuracy and/or correct account errors.
• Monitors and tracks contractual, billing, registration, and posting errors and provides continuous feedback to the department supervisor.
  
• Verifies applicable contract by reviewing EOB messages, reviewing patient ID card, and verifying member information for managed care plans.
  
• Uses good interpersonal skills to promote positive, effective interaction with customers and to promote quality service to ensure flow of information to appropriate staff and professionals.
  
• Provides detailed documentation on the collection system to explain the action taken or promise made. Obtains current information on all accounts and records information as required.
  
• Performs miscellaneous job related duties as requested.
  

To advance hope, healing and the best healthcare for children and their families

Phoenix Children's will be the leading pediatric health system in the Southwest, nationally recognized for exceptional care, innovative research and advanced medical education.

We realize this vision by:

• Offering the most comprehensive care across ages, communities and specialties
• Investing in innovative research, including emerging treatments, tools and technologies
• Advancing education and training to shape the next generation of clinical leaders
• Advocating for the health and well-being of children and families

• We place children and families at the center of all we do
• We deliver exceptional care, every day and in every way
• We collaborate with colleagues, partners and communities to amplify our impact
• We set the standards of pediatric healthcare today, and innovate for the future
• We are accountable for making the highest quality care accessible and affordable