Full Cycle Medical Billing: Charge Entry/Prior Auth/AR Follow Up

Description

Academic Urology & Urogynecology of Arizona is a premier urology practice offering compassionate patient care to individuals. This position is dedicated to serve our Interventional Radiologist.

Charge Entry Portion:

• Post charges daily
• Reviews charges for correct coding
• Audit codes for potential missed charges
• Preparing, reviewing, and transmitting claims using billing EMR
• Reconcile missing encounters

Prior Auth Portion:

• Review EMR chart messaging and review schedules daily for upcoming surgical & in office procedures
• Review chart documentations to ensure patient meets medical policy guidelines
• Prioritize authorization request according to urgency
• Obtain authorization via payer website or by phone and follow up regularly on pending cases
• Verify coverage and benefits and calculated any out-of-pocket portions due
• Contact patients to review any out-of-pocket portions due prior to surgery

AR Follow Up Portion:

-Resolve errors and make claim edits assigned in work buckets

-Follow work list prioritization of accounts as established by department policies and procedures for resolving accounts and/or submitting claims

-Contact payers and patients when necessary

-Request relevant information from appropriate Revenue Cycle and clinical departments as required through the course of the PFS Processes

-Make necessary adjustments to patient demographic, insurance, and account balance information

-Complete A/R adjustments where permitted and appropriate: request other adjustments were permitted and appropriate

-Comply with and adhere to all regulatory compliance areas, policies and procedures (including HIPAA and PCI compliance requirements) , and “leading practices

Requirements

• Minimum 1 year charge posting, prior authorization and AR follow up experience
• Understanding of payer medical policy guidelines to manage authorizations effectively
• Proficient use of CPT and ICD10 codes
• Detail oriented and above average organizational skills
• Plans and prioritizes to meet deadlines
• Ability to multitask and remain focused while managing a high volume, time sensitive workload
• Interventional Radiology (IR) experience helpful