Job: Billing Specialist - NWMC Campus - Full-Time - Days

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Job Description

Northwest Medical Center is a 300-bed hospital offering a full range of healthcare services including emergency services, accredited chest pain and heart failure programs, neurology and neurosurgery, outpatient imaging, a nationally accredited surgical weight loss program, total joint program, spine program and stroke center (recognized with Gold Seal designations by The Joint Commission), robotic surgery, GI lab, a free-standing women’s center, inpatient rehabilitation facility, wound care center, five urgent care facilities, and three ambulatory surgery centers. NMC also has several affiliated physician practices including Northwest Allied Physicians offering primary care and a wide range of specialists, Desert Cardiology of Tucson, Heart Center of Southern Arizona and Northwest Heart & Vascular. NMC is accredited by The Joint Commission and is an equal opportunity employer: race, gender, disability and Veteran status, and VEVRAA Federal Contractor - priority referral Protected Veterans requested.

Summary: Performs billing of all hospital accounts including some professional fees.  Responsible for Medicare, Medicaid, Managed Care and/or any other contract terms in accordance with compliance guidelines.

Essential Functions:
1. Preps, bills and reviews claims within 48 hours.  Researches and edits claims for accurate billing information.  Submits all requested information from PPSI/clinics/Athena/insurance companies with 48 hours..
2. Documents on system all steps taken on account so that it clearly communicates  action.  Reprobates account for accurate patient and insurance liability.
3. Works the workflow dashboard on a daily basis to ensure claims issues are completely resolved with thirty days.  Normal clean claims are to be worked and billed within 24 hours.
4. Maintains productivity standards on a regular basis as evidenced by: ability to complete assigned tasks and remain current within scheduled hours per week.
5. Works toward achieving department and individual goals, by staying current with compliance and billing requirements according to local, state, and federal laws.
6. Handles and resolves incoming rebills or correspondence within 3 days.  Responds to telephone inquiries by 10:00 am the following scheduled work day.  Identifies department and self when answering phone.  Reads and follows through on email and moxes within 48 hours.
7. May be required to provide in-service educational materials and instruction for health care professionals.  Adheres to expectations of required/mandatory in-services.
8. Demonstrates an ability to be flexible and completes all other duties as needed or requested by Supervisor, Manager and/or Department Director.
9. Able to diffuse potential problems or conflicts by handling situation, referring to coordinator/manager.


Education: High School Diploma or equivalent

Experience: One (1)  year billing experience  in hospital settings, and knowledge of hospital billing requirements.

Skills: Balance figures, compile statistics, computer literacy, develop office procedures, date input, maintain filing systems and logs, research information.


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