Payer Resolution Specialist - Phoenix, AZ - Sign on Bonus up to $7,500 effective through 01/31/2023 - Phoenix, AZ

JOB SUMMARY

Analyze payer denials and payments to determine proper resolutions within the software system.
Assist the Revenue Cycle Manager to determine root causes of denials or low payments.
Assists with other special activities and responsibilities as required.
Contact payers and determine best contact and responsible party for proper resolutions.
Contact insurance companies for payer resolutions status.
Designs/utilizes a variety of reports to identify payer behavior.
Participates in staff meetings and recommends claim requirement changes to ensure a clean claim is processed to the payer.
Responsible for generating and distributing daily, weekly, and monthly payer resolution reports.
Review, analyze, and evaluate payer information to determine resolution.
Resolve payer issues in a timely and compliant manner for maximum reimbursement.
Work closely with PFS Staff for status of claims or review of expected results from payer.
Maintains a strict level of confidentiality for all company, departmental, and healthcare provider information.
Perform other duties as requested.

JOB SUMMARY/LOCATION

QUALIFICATIONS/EXPERIENCE

Detailed knowledge and ability to understand payer regulations and requirements.
Billing/Revenue Cycle knowledge required.
Advanced Excel knowledge required.
Excellent work habits, including a willingness to work the hours necessary to get the job done.
This position is designated Safety Sensitive for purposes of the Arizona Medical Marijuana Act.

CORE COMPETENCIES

Safe. We are absolute in our belief in the tenets of Destination Zero and that Zero is not only achievable, but the only acceptable outcome.
Efficient. We are focused on outcomes that are smart and responsible by making the best use of our resources to maximize overall productivity and achieve sustainable profitability as a high performing organization.
Quality. We are committed to ensuring excellent organizational performance which produces sustainable and reliable outcomes.
Service. We are dedicated to the service of our customers, our communities and each other.

BEHAVIORAL COMPETENCIES

Drive & Energy – The ability to maintain a fast pace and continue to produce during exhausting circumstances.
Functional & Technical Expertise – Allows the individual to add organizational value through unique expertise and serve as a resource to the organization within his/her area of expertise
High Standards – Sets the stage for continuous improvements, the adoption of best practices and ultimately influences organizational standards.
Initiative – Takes a proactive approach and takes action without being prompted.
Integrity – Acts ethically and honestly and applies those standards of behavior to daily work activities.

Hiring Manager: Martha Greer