Medical Billing Clerk - Phoenix, United States - Adobe Care And Wellness LLC

Description

Job Description

Adobe Population Health (APH) is a women-owned health solutions company founded in 2018 and committed to positively impacting the lives we touch. The company has a culture of inclusivity and human kindness, based in Phoenix, AZ, with satellite locations in multiple states. APH has been recognized as one of "America's Fastest-Growing Private Companies" by Inc. 5000 and has earned a "Best Places to Work" award from the Phoenix Business Journal consecutive times.

APH offers customized programs for insurance groups, providers, hospitals, and families, which include case management, in-home/in-clinic wellness assessments, preventative care, transitional care, and social work services. As one of the country's few fully integrated healthcare providers, APH provides top-notch medical services with various service lines. The company is expanding and looking for individuals who want to make a difference and help those in need.

POSITION PURPOSE

Adobe Population Health is seeking a passionate and results-oriented individual to join our team as an Accounts Receivable Clerk. As the Clerk, you will be acting in a professional manner to handle the billing and payment processes for medical services. In this role, you are responsible for ensuring that the revenue cycle is efficient and accurate, and that payers are billed correctly. They also perform some of the duties of a medical biller, such as actively managing submitted claims, following up on denials and rejections, and applying received payments. The ideal candidate will possess excellent communication skills, a strategic mindset, and a passion for delivering exceptional customer experiences.

This newly created position supports APH's continued expansion and reports to the Accounting Manager.

This role is based out of our Phoenix Office, conveniently located off the 51 Freeway (Glendale Ave. and 16th St.).

DUTIES & RESPONSIBILITIES

Managing Claims (60%)

• Monitoring the status of claims in the clearinghouse and resolving any issues or errors.
• Resubmitting denied and rejected claims with appropriate ICD-10 and CPT codes through the clearinghouse.
• Collaborating with the IT team to update and maintain billing records and databases.
• Collaborating with the medical coding team and IT team to identify and implement strategies to improve billing efficiency and accuracy.

Reporting & Reconciling (25%)

• Reconciling accounts and generating reports on revenue cycle performance.
• Reconciling EHR data with claims data submitted to health plans to proactively identify missing or inaccurate claims.
• Preparing, maintaining, and analyzing aging reports and statements.
• Communicating with internal teams and payers to address any questions or concerns.

Invoicing & Collections (10%)

• Generating and sending invoices to payers for events and other services.
• Reconciling and applying received payments, adjustments, refunds, and write-offs against invoices.
• Tracking and verifying outstanding balances and invoices.

Other (5%)

• Maintain compliance with federal, state, and local regulations and policies.
• Perform other clerical and administrative tasks as assigned.

SKILLS & QUALIFICATIONS

• 3+ years in accounts receivable related roles.
• 1+ year in healthcare setting.
• Proactive/Self-Starter Mindset.
• Strong Analytical and Critical Thinking Skills.
• Detail Oriented and Highly Organized.
• Curiosity and Flexibility.
• Experience with Change Healthcare.
• Experience with Salesforce.
• Experience with Sage Intacct.
• Basic understanding of Generally Accepted Accounting Principles (GAAP).
• Customer-centric approach with a passion for delivering exceptional experiences.

EDUCATION, LICENSES, & CERTIFICATIONS

• High School Diploma or equivalent required.
• Associate's degree preferred.
• AAPC Certified Professional Coder (CPC) Certification is REQUIRED.
• AAPC Certified Professional Biller (CPB) Certification is strongly preferred.

BENEFITS & TOTAL REWARDS

• Paid Onboarding and Training
• Insurance – Medical, Dental, Vision, and Life
• 401k Plan – 3% match
• Employee Assistance Program
• Tuition Reimbursement
• Continued Education Support
• Mileage Reimbursement (if applicable)
• Referral Bonuses
• 8 Paid Holidays
• 15 Days of Paid Time Off
• Paid Volunteer Hours

CHARACTER & COMPETENCIES

• Diversity - Demonstrates knowledge of EEO policy; Shows respect and sensitivity for cultural differences; Educates others on the value of diversity; Promotes a harassment-free environment; Builds a diverse workforce.
• Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethics; Upholds organizational values.
• Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events.
• Analytical - Synthesizes complex or diverse information; Collects and researches data; Uses intuition and experience to complement data; Designs workflows and procedures.
• Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
• Dependability - Follows instructions, responds to management direction; Takes responsibility for own actions; Keeps commitments; Commits to long hours of work when necessary to reach goals; Completes tasks on time or notifies appropriate person with an alternate plan.
• Interpersonal Skills - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things.
• Judgement - Displays willingness to make decisions; Exhibits sound and accurate judgment; Supports and explains reasoning for decisions; Includes appropriate people in decision-making process; Makes timely decisions.
• Problem-Solving - Identifies and resolves problems promptly; Gathers and analyzes information skillfully; Develops alternative solutions; Works well in group problem-solving situations; Uses reason even when dealing with emotional topics.
• Professionalism - Tactfully approaches others; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments.
• Teamwork - Balances team and individual responsibilities; Exhibits objectivity and openness to others' views; Gives and welcomes feedback; Contributes to building a positive team spirit; Puts success of team above own interests; Able to build morale and group commitments to goals and objectives; Supports everyone's efforts to succeed.

PHYSICAL DEMANDS & WORK ENVIRONMENT

• Occasionally required to stand.
• Occasionally required to walk.
• Continually required to sit.
• Occasionally required to climb, balance, bend, stoop, kneel, or crawl.
• Occasionally required to be exposed to warm or cool spaces.
• Continually required to talk or hear.
• While performing the duties of this job, the noise level in the work environment is usually moderate.
• May occasionally lift and /or move more than 30 pounds.
• Must be able to physically perform the essential duties of the position which include lifting 30 lbs., transporting materials, stooping, kneeling, crouching, reaching, use of hands, balancing, walking, standing, talking, hearing, and typing.

EQUAL EMPLOYMENT OPPORTUNITY

APH is an Equal Opportunity Employer where all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.