Job Description

Accounts Receivable Rep III - Hybrid Remote Schedule Available

3033 N. Central Ave Suite 145, Phoenix, AZ 85012

Who Are We?

At Adelante Healthcare, we believe that healthy people create healthy communities. Our mission is to improve the health of our communities by providing the highest level of primary and preventive care, making it affordable for everyone. For over 40 years, we have been dedicated to serving our communities by providing healthcare to those most vulnerable by offering health care services at nine locations throughout Maricopa County. By joining the Adelante Healthcare team, you become part of a patient centered caring organization that is playing a vital role in helping our communities.

OUR AMAZING BENEFITS

We offer a culture that values caring, professional development, growth, and sustainability. We provide a comprehensive and competitive benefits program including:

· Medical, Dental, and Vision available DAY ONE!

· 3 weeks Paid Time Off annually

· 10 paid Holidays annually

· 403b Retirement Account Savings Plan

· Tuition Reimbursement for eligible programs

· Employer-paid Short Term and Long Term Disability

· And MORE

POSITION SUMMARY

The Accounts Receivable Representative III will be responsible for reviewing all outstanding insurance claims, including denials, make claim corrections, complete the appeal process, and adjust balances when appropriate.

WHAT YOU'LL NEED TO HAVE

• Associates degree preferred
• High school diploma or GED from an accredited institution
• Five (5) years of medical billing experience in a large medical practice setting, preferably including family medicine, pediatrics or OBGYN specialties
• CPT4 and ICD10 coding knowledge
• Ability to read and understand explanation of benefits and ANSI/remark codes
• Ability to research correct coding policies/guidance and payer policies
• High attention to detail and the ability to multi-task
• Excellent written and verbal communication skills
• Excellent analytic and problem-solving skills
• Demonstrated progressive advancement within the medical billing industry
• Experience with Microsoft Excel and Word
• Valid Level One Fingerprint Clearance Card issued by the Arizona Department of Public Safety for all specialty behavioral health locations

WHAT YOU'LL BE DOING DAY TO DAY

• Review outstanding claims to determine necessary action
• Make status calls to insurance companies
• Request claims to be reprocessed when necessary and prepare/submit corrected claims or appeals to the insurance companies for payment
• Adjust claims that are deemed non-reimbursable
• Call payers to determine true reason for denial and inquire on what corrections need to be made
• Work with the coding team when necessary to make coding changes to submit corrected claims/appeals
• Follow company processes related to submission of corrected claims and appeals
• Develop and maintain denial management process, including but not limited to creation of appeal of letters and denial tracking
• Analyze root causes of denials
• Share trends and feedback with management aimed at the reduction of denial volume

***As a community health center, we have a unique responsibility to keep our facilities as safe as possible and to protect our patients and team members. With this in mind, you will be required to comply with all vaccine mandates, including the COVID-19 and Flu Vaccine programs which will include acquiring the vaccines or an exemption. This policy is consistent with our mission to provide a safe and healthy environment for our patients, providers, and employees.

As an Affirmative Action and Equal Opportunity Employer, Adelante Healthcare is committed to creating an inclusive environment that values the diversity of its employees and does not discriminate against any employee or candidate. Women, minorities, veterans, people from the LGBTQ communities, and people with disabilities are strongly encouraged to apply.***

Job Type: Full-time

Pay: From $21.00 per hour

Benefits:

• Dental insurance
• Disability insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Tuition reimbursement
• Vision insurance
• Work from home

Schedule:

• 8 hour shift

Ability to commute/relocate:

• Phoenix, AZ 85012: Reliably commute or planning to relocate before starting work (Required)

Education:

• High school or equivalent (Required)

Experience:

• relevant billing: 5 years (Preferred)

Work Location: In person

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