Pediatric Medical Billing Specialist

4 weeks ago


Phoenix, Arizona, United States Patterson Schlotterer Medical Group Full time

Job Summary:

We are seeking a highly skilled Pediatric Medical Billing Specialist to join our team at Patterson Schlotterer Medical Group. As a key member of our revenue cycle team, you will be responsible for ensuring accurate and timely processing of medical claims.

Key Responsibilities:

  • Oversee daily processing and submission of claims from our practice management system to the clearinghouse and third-party payors.
  • Continuously work the A/R and denials to prevent losses from timely filing and research denials to keep us informed accordingly.
  • Proactively monitor for errors and issues and promptly resolve them to ensure payments are processed as not to exceed the timely filing rules.
  • Resolve edits related to coding; obtain and review relevant documentation and ensure documentation supports services billed.
  • Oversee the insurance correspondences, such as Explanation of Benefits (EOB) and Coordination of benefits and researches appropriate claims steps, such as first or second appeal.
  • Communicates with insurance carriers to track and check status of appeals.
  • Work with insurance payors to ensure timely and accurate payments.
  • Troubleshoot patient account issues, including direct resolution of billing issue with patients.
  • Ensure accurate patient statements are sent out monthly along with analyzing patients accounts and recommend to collections accordingly.
  • Ensure credentialing and privileging is accurately maintained with all payors and facilities, including the re-credentialing cycle.

Requirements:

  • Pediatric experience: 1 year (required)
  • Medical billing experience: 2 years (required)
  • EClinical Works experience (preferred but not required)

Work Environment:

This is a full-time position. Punctuality and forward thinking are a must.

Job Type: Full-time / In-person



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