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Position Details

Department: Managed Care Contracting
Category: Any
Location: Phoenix
Posting #: 329985
Date Posted: 3/15/2017
Employee Type: Regular

Position Summary

Posting Note: #PCHCB

This position performs a variety of tasks to coordinate and facilitate all billing activities by following transplant patient accounts through the billing process to payors. This position also oversees patient account data verification to ensure timely and accurate billing, payment tracking, and account follow-up for all transplant-related services.

PCH Values

  • Family-Centered care that focuses on the need of the child first and values the family as an important member of the care team
  • Excellence in clinical care, service and communication
  • Collaborative within our institution and with others who share our mission and goals
  • Leadership that set the standard for pediatric health care today and innovations of the future
  • Accountability to our patients, community and each other for providing the best in the most cost-effective way.

Position Duties

  1. Actively monitors all accounts receivable for transplant patients.
    • Identifies and follows all transplant patient accounts to ensure transplant related services are posted properly in the billing systems and captured in the transplant database.
  2. Submits bills electronically or manually, as required, for transplant related services.
    • Prepares clean claims for submission as soon as possible to secure timely payment. Requests and attaches any required clinical documentation.
  3. Remains current in knowledge of regulatory and payor billing requirements.
    • Interprets claims processing reports; corrects patient demographic information as necessary to produce clean claims.
  4. Prepares all accounts payable requests for manager approval for timely payment.
    • Processes vendor claims/invoices for submission within appropriate transplant phase of global period.
  5. Ensures pertinent transplant account data is entered into transplant database.
    • Maintains detailed claim and other financail information in transplant database.
  6. Services accounts in accordance with priority to optimize turnaround time.
    • Bills accounts independently (rather than in batches) based on applicable insurance and CMS requirements.
  7. Performs miscellaneous job related duties as requested.

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Position Qualifications

Please review the following qualifications and specify whether you meet each of the requirements listed.
Do you meet this requirement?
Education
1. Associates degree in accounting, finance, business or closely related field. Two years work experience may substitute for degree. Required
Do you meet this requirement?
Experience
1. Two years hospital services and/or medical professional services billing experience. Required
Do you meet this requirement?
Special Skills
1. Experience with Medicaid, Medicare and third party payor billing requirements. Required
2. Experience with CPT-4, HCPCS and ICD-9 diagnosis coding and facility revenue coding. Required
3. Experience with various billing systems and Windows applications. Preferred
4. Experience with Allscripts AMPFM and SCM applications. Preferred
Physical Requirements & Occupational Exposure/Risk Potential
1. Physical Requirement - Fine Motor Skills (pinching, gripping, etc) Occasionally
2. Physical Requirement - Hearing Frequently
3. Physical Requirement - Pushing/pulling Occasionally
4. Physical Requirement - Reaching Occasionally
5. Physical Requirement - Sitting Constantly
6. Physical Requirement - Standing Occasionally
7. Physical Requirement - Stooping/crouching/kneeling/crawling Occasionally
8. Physical Requirement - Talking Frequently
9. Physical Requirement - Walking Occasionally
10. Physical Requirement - Near Vision Constantly
11. Physical Requirement - Far Vision Occasionally
12. Physical Requirement - Color Discrimination Occasionally
13. Physical Requirement - Use of keyboard, mouse and/or computer equipment Constantly
internal/external
I have reviewed the qualifications, physical requirements and occupational exposure/risk potential for this position and wish to apply