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Position Details

Department: Physician Revenue Cycle
Category: Patient Financial Services
Location: Phoenix
Posting #: 532026
Date Posted: 10/16/2020
Employee Type: Regular

Position Summary

Posting Note: *Medical insurance collections experience required

This position performs Accounts Receivable and Credit Resolution duties in accordance with established federal and state regulations.

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. Performs account follow-up on outstanding credit balances and takes the necessary action for account resolution in accordance with established federal and state regulations. Audits and reviews both PRC and HRC accounts for possible transfers of patient overpayment`s to resolve any patient responsibility of outstanding balances.
    • Reviews and analyzes all credit balances to ensure the credit balance is valid. Pulls EOBs to submit to insurance with the necessary documentation for return of overpayment. Audits accounts for validity of overpayment`s and adjustments.
  2. Verifies insurance payment is in alignment with payer contract by reviewing the fee schedules loaded into MPV.
  3. Provides detailed documentation on the collection system to explain the action taken. Documents comments into account regarding credit balance and resolution.
  4. Monitors and tracks refund check request spreadsheet to ensure receipt. Maintains master spreadsheet of all refunds both patient and insurance with check numbers and dates of checks mailed.
  5. Establishes and maintains effective communication with collectors, insurance companies and other internal departments to secure accurate and pertinent information to process refunds.
  6. Responsible for achieving and maintaining credit balance days at the established percentage goal.
  7. Uses good interpersonal skills to promote positive, effective interaction with colleagues and to promote quality service to ensure flow of information to appropriate staff and professionals.
  8. 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 health care, business, or closely related field, or equivalent work experience. Required
Do you meet this requirement?
Experience
1. Two years experience with collection activity and reduction in accounts receivable in a health care setting. Required
2. Experience with AHCCCS billing laws and regulations, third-party and managed care payer billing requirements, registration, verification and centralized computer systems. Preferred
3. Experience with medical terminology and HIPPA Preferred
Do you meet this requirement?
Special Skills
1. Effective time management skills and ability to multi-task. Required
2. Strong MS Office skills with a focus on Excel Required
Physical Requirements & Occupational Exposure/Risk Potential
1. Physical Requirement - Climbing Occasionally
2. Physical Requirement - Feeling (sensing textures and temperatures) Occasionally
3. Physical Requirement - Fine Motor Skills (pinching, gripping, etc) Constantly
4. Physical Requirement - Hearing Constantly
5. Physical Requirement - Pushing/pulling Frequently
6. Physical Requirement - Reaching Frequently
7. Physical Requirement - Sitting Constantly
8. Physical Requirement - Standing Frequently
9. Physical Requirement - Stooping/crouching/kneeling/crawling Occasionally
10. Physical Requirement - Talking Constantly
11. Physical Requirement - Walking Constantly
12. Physical Requirement - Near Vision Constantly
13. Physical Requirement - Far Vision Frequently
14. Physical Requirement - Use of keyboard, mouse and/or computer equipment Constantly
15. Physical Requirement - Lift up to 35 pounds without assistance Occasionally
16. Physical Requirement - Lift more than 35 pounds without assistance Occasionally
17. Occupational Exposure/Risk Potential - Inside office environment Applicable
internal/external
I have reviewed the qualifications, physical requirements and occupational exposure/risk potential for this position and wish to apply