Patient Account Rep. Level Ii

3 weeks ago

Phoenix, United States Pathology Billing Services Full time

**This position is fully in office Mon
- Fri 7:00 am - 4:30 pm ((Transitioning to hybrid schedules soon)**

**Located in North Phoenix - 1929 W Lone Cactus Dr., Phoenix, AZ 85027**

**JOB SUMMARY**:
**Must have the following experience with**:

- Must have experience working medical denials and submitting 1st and 2nd level appeals.
- Must have strong understanding payor guidelines.
- Ability to identify and research payor trends and issues.
- Must have strong experience with coding/payor edits such as NCCI Edits, LCD, & Bundling.
- Must be able to read and understand EOBs.

The Patient Account Rep. Level II provides comprehensive advanced collection activity support to Pathology Billing Services, LLC, to enhance the liquidation of the accounts receivables. All employees are responsible for supporting the company’s goals and mission, by following all company policies and procedures.

**ESSENTIAL FUNCTIONS**:
Act as coordinator for resolving outstanding receivables on whole or partial balance accounts as assigned for AHCCCS and Medicare receivable.

Maintain updated knowledge of the group’s contractual agreements and report any discrepancies in payors reimbursement patterns to the Billing Manager in writing.

Facilitate communication between PBS, LLC and patient clientele.

Assist management with special projects and tasks as requested.

Monitor payment activity and contractual adjustments posted to patient accounts. Initiate corrections, if posting of inaccurate transactions are determined.

Obtain status and secure payment on all accounts greater than 45 days aged.

Accounts less than 45 days will be monitored and appealed if payer has acknowledged or assigned.

Maintain spreadsheets and documents for payer reimbursement as required.

Follow-up with payors regarding reimbursement claims in the following interval and status or as defined by management:Claims that have received denials for erroneous reasons; follow-up initiated and completed within 10 business days or receipt of notification.
Claims that require additional documentation; follow-up initiated and completed within 10 business days or receipt of notification.
Claims that have not been acknowledged; follow-up initiated and completed within 10 business days after receipt.

Initiate first and second level appeal, grievances, reconsiderations, redeterminations, and all categories of disputes required to secure reimbursement.

Manage the hearing process from request to mediation.

Initiate the process of filtering unpaid patient balanced accounts for outside agency. Completing thorough and accurate assessment that there is not a responsible third party, patient has been properly notified and efforts to locate payment have been exhausted.

Maintain updated knowledge of provider manuals and billing guidelines.

Report any inconsistencies in payer activity, workflows or software to the Billing Manager in writing.

Assist and resolve all patient inquires through incoming calls.

Maintain minimum average monthly of 1675 patient accounts.

**ADDITIONAL FUNCTIONS**:
Assist with billing duties as needed.

Meet assigned deadlines and communicate status with management.

Assist with mailing of claims and correspondence as needed.

Complete status reports daily or as instructed.

Assist with special projects as needed.

Notify billing manager of any inconsistencies, changes, or errors with payor activity.

All other duties as assigned.

**MINIMUM QUALIFICATIONS**:

- One to Five years of advanced billing support experience in a corporate setting.
- AHCCCS and Medicare Payor experience required.
- Exceptional verbal and written communication skills to be utilized in interfacing with all levels of management.
- Excellent organizational skills and ability to manage multiple and diverse priorities simultaneously, meeting deadlines as required.
- Ability to handle highly confidential information.
- Ability to exercise independent judgment.
- Knowledge of standard office equipment.
- Ability to lift a minimum of 35 pounds and sit for long periods of time.

**Benefits**:
Pathology Billing Services, LLC, offers nationally competitive compensation and benefits. Our benefits program provides a comprehensive array of services to our employees including, but not limited to health insurance (Primarily covered by the company), dental insurance (100% covered by the company) vision insurance, paid time off, retirement contributions (401k), & flexible spending account (FSA).

Pay: $19.00 - $23.00 per hour

**Benefits**:

- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance

Schedule:

- 8 hour shift

**Experience**:

- AHCCCS & Medicare: 2 years (required)
- Medical AR billing: 2 years (required)
- Medical denials & appeals: 2 years (required)

Work Location: In person

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