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
- 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