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Job Details
Job Order Number
Company Name
Gila River Health Care
Job Site Location

Sacaton, AZ 85147
Job Description

6 Month Navigator Position – Gila River Indian Community Members Only

Compiles, processes and maintains accounts receivable records by performing the following duties personally. Responsible for ensuring that all critical tasks are fulfilled on a timely basis.

+ Prepares and submits accurate, complete and timely statements of resident charges to payers.

+ Prepares adjustments to billings for approval by management.

+ Communicates accurately, clearly and professionally with providers and payers, in writing and verbally.

+ Reviews, adjusts and processes remittance advice forms by verifying accuracy and completeness of forms to ensure timely and accurate reimbursement by third party payers of medical services rendered.

+ Communicates with third party payers regarding disputed and/or denied claims and as necessary provides copies of necessary documents to facilitate timely reimbursement of medical services charges.

+ Answers all payer inquiries on a rapid and accurate basis.

+ Accurately performs data input for services provided as well as other financial information into accounting system.

+ Receives and reviews daily, weekly and monthly production/error reports and Explanation of Benefit statements to identify errors and makes all necessary corrections.

+ Performs accurate data entry of information into patient billing system from source documents generating UB92 and/or 1500 claim forms based on service types and procedures performed.

+ Creates, edits, validates, enters, and prints all insurance claim data.

+ Performs follow up as needed to ensure reimbursement of all charges.

+ Verifies accuracy of resident charges from all sources. Verifies system information and validates encounter documentation. Collaborate with admissions staff regarding patient/resident census data.

+ Prepares and submits accurate, complete statements of resident charges to appropriate payers. Prepares adjustments to billings for approval.

+ Maintains and updates payer information system data on a timely basis.

+ Prints all accounts receivable reports and maintains all accounts receivable files.

+ Manages all receivables data on an accurate and ethical basis without loss of data.

+ Reviews patient registration information for updates and/or changes to primary and secondary insurance coverage for billing accuracy purposes.

+ Issues resident notifications of medical billing information as required, performs insurance verifications, and maintains all claim activity data.

+ Prepares analyses of accounts as required.

+ Complies with all regulatory requirements regarding patient/resident personal information.

+ Assists in monthly closings.

+ Notifies all necessary executives and authorities regarding any inappropriate activities or results regarding financial activities.

+ Assists with accounts payable subjects and activities as necessary.

+ Assists in the preparation and distribution of reports, documents and other correspondence to departments as appropriate.

+ Demonstrates ability to regularly change priorities to accomplish all tasks despite frequent interruptions.

+ Demonstrates ability to clearly communicate, both orally and in writing, while performing all essential functions.

+ Performs other special projects and duties as assigned.

+ High School diploma, with Associates Degree preferred.

+ AMBA and AAPC Certifications required with prior experience in a health care environment also required.

+ 2 to 4 years of Medicare, AHCCS and RPMS billing experience preferred.

+ ICD9 and CPT coding experience is required.

+ Demonstrated ability to relate to diverse cultures and specifically the Gila River Community and/or other Native American cultures.

+ Interest in medical subjects, patient services/care, and customer service.

+ Prior medical environment work experience is required.

Posting Title: Biller

Department: Revenue Cycle

Job ID: 2019-6240

Street: 483 West Seed Farm Road

Shift: Days

Email Address: larredondo@GRHC.ORG

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