Accounts Receivable Recovery Specialist
Dignity Health Medical Group is the employed physician group of Dignity Health Arizona. Dignity Health Medical Group (DHMG) employs approximately 200 providers and 500 support staff that cover a wide variety of specialties. The medical group has had tremendous success over the past few years and now provides more than 73 subspecialty services.
The physicians provide clinical services in their areas of specialty and many serve in pivotal academic, research and leadership roles.
DHMG is also heavily involved in preparing tomorrow's healthcare providers. DHMG has 84 medical school students and approximately 200 residents and fellows throughout the 25 academic programs. Clinical services are complemented with translational and bench research to augment medical education for residents and students.
The mission of Dignity Health Medical Group is consistent with Dignity Health's mission and St. Joseph's guiding principles with a focus on innovative clinical care and the pursuit of excellence through scholarly activities. As part of the Dignity Health hospital system, DHMG has full access to the staff and all facilities on our hospital campuses. This unique relationship with our hospital allows Dignity Health Medical Group to provide its patients with state-of-the-art patient services including care of the poor and disenfranchised.
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Responsibilities
SUMMARY - Accurately reviews record for coding errors and corrects diagnostic and procedural codes in billing system for the purpose of reimbursement utilizing ICD-9-CM, CPT, HCPCS, and proper modifiers. Must be able to identify and communicate payer and/or system trends to Management. Maintains thorough knowledge of payer contracts, regulations and guidelines, as well as state and federal laws relating to billing and collection procedures to ensure accurate and compliant billing processes. Communicate with courtesy and tact to fellow employees and external customers to promote better quality and more efficient customer service.
Qualifications
MINIMUM
HS graduate, plus at least three (3) years of experience required
Certified professional coder (CPC, CCA, CCS-P) required
Three (3) years prior experience in medical coding and/or billing for physician office services
Proficiency assigning ICD-9-CM , CPT, HCPCS , and modifiers
Ability to read and comprehend an EOB
Proficient in guidelines, CCI, LMRP, coding, use of modifiers
Ability to research CPT/ICD9 codes to bill appropriately
Adept in physician and insurance reimbursement and billing concepts and procedures, as well as laws and regulations affecting payment compliance, denials and appeals recovery
Proficient understanding of medical coding systems effecting the adjudication of claims payment
Proficiently utilizes MS Office applications, including MS Excel and MS Access
PREFERRED
Five (5) years work experience in medical billing and coding for physician office services preferred
Associate's degree
Degree, plus at least five (5) years of experience preferred. Proficient in all aspects of reimbursement (i.e., benefit investigations, payer reimbursement policies, regulatory and administrative rules).
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