Hospital Collections Specialist (Remote – AZ Residents Only)

Posting Note: Hospital Collections Specialist Location: Fully Remote - Arizona Residents ONLY Schedule: Monday–Friday Flexible schedule between 6:00 AM – 5:00 PM Core Required Hours - 8:30 AM – 2:30 PM Weekly Requirement: Employees must complete 40 total hours weekly

Required Qualifications

Minimum 2 years of collections experience Hospital/facility billing experience REQUIRED AHCCCS experience REQUIRED Medicare knowledge REQUIRED Government payer experience strongly preferred Strong understanding of denial management and appeals processes Role Summary We are seeking an experienced Hospital Collections Specialist to support hospital revenue cycle operations with a focus on: Medicaid/AHCCCS collections Insurance follow-up Appeals processing Denial management Claims resolution and reimbursement recovery

Key Responsibilities

Contact insurance companies regarding unpaid or underpaid claims Submit and manage claim appeals Follow up on denied claims and resolve discrepancies Ensure claims are processed accurately and reimbursed appropriately Work managed care and government payer accounts efficiently This position oversees the collection activity for an assigned segment of the Accounts Receivable and performs collection duties in accordance with established federal and state regulations. Position Duties

• Performs account follow-up on outstanding insurance balances and takes the necessary action for account resolution in accordance with established federal and state regulations.

Contacts all assigned accounts in the work queue daily and provide sound collection follow-up on outstanding insurance balances.

• Batches, compiles, submits appeals and monitor accounts for proper reimbursement.

Responsible for achieving and maintaining accounts receivable days at the established goal.

• Establishes and maintains effective communication with employers, other healthcare providers, insurers, and patients/families to secure accurate and pertinent information to maximize reimbursement.

Communicates with internal and external customers by telephone and mail to verify charge accuracy and/or correct account errors.

• Monitors and tracks contractual, billing, registration, and posting errors and provides continuous feedback to the department supervisor.
• Verifies applicable contract by reviewing EOB messages, reviewing patient ID card, and verifying member information for managed care plans.
• Uses good interpersonal skills to promote positive, effective interaction with customers and to promote quality service to ensure flow of information to appropriate staff and professionals.
• Provides detailed documentation on the collection system to explain the action taken or promise made. Obtains current information on all accounts and records information as required.
• Performs miscellaneous job related duties as requested.

Phoenix Children's Mission, Vision, & Values Mission To advance hope, healing and the best healthcare for children and their families Vision Phoenix Children's will be the leading pediatric health system in the Southwest, nationally recognized for exceptional care, innovative research and advanced medical education. We realize this vision by:

• Offering the most comprehensive care across ages, communities and specialties
• Investing in innovative research, including emerging treatments, tools and technologies
• Advancing education and training to shape the next generation of clinical leaders
• Advocating for the health and well-being of children and families

Values

• We place children and families at the center of all we do
• We deliver exceptional care, every day and in every way
• We collaborate with colleagues, partners and communities to amplify our impact
• We set the standards of pediatric healthcare today, and innovate for the future
• We are accountable for making the highest quality care accessible and affordable

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