Air Ambulance, Medical Flights, Air Ambulance Services, Medical Health Care, International Air Ambulance
  • International480-634-8017
  • Toll Free877-264-3570

Claims Specialist I (Scottsdale, AZ)



Description:


    The primary purpose of this position is to adjudicate claims and liaison by communicating and resolving root cause analysis (RCA) between billing and follow-up to ensure maximum reimbursement to AMF. Acts as a focal point within the company for all revenue cycle activities.


Skills Required:


  • ESSENTIAL DUTIES & RESPONSIBILITIES:
  • Works with insurance companies, billers, Flight Coordination and leadership to ensure reimbursement is maximized for AMF.
  • Analyzes workflow and operational procedures to identify opportunities for improved reimbursement, develops and implements policies and procedures with leadership to ensure all services are captured, recorded, processed and billed in an accurate and timely manner.
  • Ensures payment is received, credited and recorded at contracted rates. Identifies and researches discrepancies through data analytics and root cause analysis to improve upstream processes.
  • Analyzes billing and accounts receivable reports. Identifies payor trends, categories of aged receivables and provides feedback to stakeholders to improve results. Works with payors and Flight Coordination personnel to identify trends and implement strategies that ultimately save cost and improve revenue lift.
  • Works with Legal team to ensure proper payment is received and highlights trends of payor underpayments.
  • Maintains a working knowledge of Eligibility and Benefits, Insurance, authorization, and SPD Salesforce sections.
  • Reviews, modifies and recommends changes to policies and procedures to improve Accounts Receivables Days.
  • Meets regularly with Revenue Cycle leadership to address reimbursement and data needs and recommends target areas for reimbursement improvement.
  • Prepares and distributes monthly reimbursement/revenue cycle reports for departments. Downloads appropriate data from system and compiles information in a user-friendly understandable manner. Reports include target vs. actual collection rates and actual vs. target Accounts Receivable (A/R) days.
  • Monitors insurance cash collections policies and procedures and educates Flight Coordination staff to ensure best practice sharing across company.
  • WORKFLOW/PROCESS IMPROVEMENT:
  • Ensures Revenue cycle goals and productivity standards are met for optimum utilization
  • Helps identify methods to improve service delivery

Educational Requirements:


  • QUALIFICATIONS:
  • REQUIRED:
  • Education: High school diploma or GED
  • Experience: A minimum of three years in a healthcare environment or work related experiences and/or educational accomplishments with knowledge of the following functions: CPT coding, HCFA 1500 billing requirements, quantitative reporting methods and systems, project management, data analytics, and Salesforce. A combination of both will be considered.
  • The ability to work independently, handle multiple tasks and exhibit problem-solving skills are essential.
  • PREFERRED:
  • Education: Bachelor’s degree
  • Experience: Process Improvement skills (Lean, Six Sigma, Process Excellence)
  • Healthcare and revenue cycle experience (medical billing, collections)
  • Experience reviewing 1500 claims
  • SalesForce.com experience. Knowledge of collections, reimbursement and Salesforce is highly preferred.

To Apply:


If you fullfill above requirements please use our Online Employment Form. Alternatively, you can send us your Resume, Cover letter and completed Employment Application at: careers@angelmedflight.