Senior Third Party Billing Specialist

Job SummaryThe Senior Third Party Billing Specialist verifies billing claims and documents receipt of co-payments from patients, AHCCCS reimbursements, and third party payments from outside insurance carriers. The incumbent will use an electronic tracking system, requiring input of outstanding invoice and receipt of payments. This position will post payments and reconciles vendor accounts, contact vendors about outstanding medical accounts; addresses invoice disputes and assist with the resolution of complex billing issues. The Senior Third Party Billing Specialist assists the Billing & Collections Supervisor with account review and quality control issues.Principle Duties and ResponsibilitiesSet up account records, computes accounts receivables, records payments, process accounts payables, reconcile ledger accounts, prepare related reports and monitor accounts for necessary compliance. Process, review, and route a variety of financial forms, reports, verifications, third-party billings, verification of insurance plans, patient eligibility, and other documents. Provide complex, specialized billing support for the Health Department by responding to general billing inquiries, conduct research, prepare and send billing collection notices, maintain and update departmental files, data and/or other related documents. Assist supervisor by reviewing invoices and documents for compliance with operational procedures; ensure accuracy and completeness. Assist supervisor with preparing documentation for legal department in collection proceedings. Prepare extensive review, research, and analysis of various documents to determine an appropriate billing code. Assist supervisor with Billing & Collection Unit training and updating internal policies and procedures. Provide customer service to employees and public; answer questions, review forms, and refer issues to appropriate personnel when needed. Prepare fiscal related reports as needed for assigned area; research and verify accuracy of necessary data. Maintain the department billing files and related operational information. Perform other duties of a similar nature or level as requested by supervisor or director.Knowledge OfRequired Knowledge, Skills, and AbilitiesMedical and/or Behavioral Health Terminology; All Insurance to include Medical, Dental and VisionPlan eligibility requirements and billing guidelines; CPT-4, ICD-10 and HCPCS codes; HCFA 1500s and UB-92s; Basic Accounting, clerical and office support practices; Quality control best practices; Manual and/or electronic systems for processing third party insurance billing; Health Division operations and functions; Customer service principles; Recordkeeping principles; Mathematical concepts; English language, grammar, and punctuation; Report preparation techniques; HIPAA and Confidentiality policies; Federal, State and Tribal regulations and policies for insurance claim processing; Yaqui culture, customs, resources and traditions and/or a willingness to learn.Skills and Abilities:Apply accounting principles and practices; Maintain files and records; Apply and explain applicable laws, codes, regulations, policies, and/or procedures; Compile and maintain statistical data for billing & collections; Perform account audits; Prepare reports on outstanding receivables for management review; Using proper English grammar, punctuation, and spelling; Provide customer service; Follow oral and written instructions, policies, and procedures; Operate a variety of office equipment, including a computer and related software applications; Good communication and interpersonal skills as applied to interaction with co-workers, supervisor, management, Council members, and the public. Have ability to sufficiently exchange or convey information and receive verbal and written work instructions.Education, Certifications And Experience RequiredHigh School Diploma or G.E.D plus and three (3) year of work experience with Medical Billing and/or Coding; and experience sufficient to successfully perform the essential duties of the job such as those listed above.ANDAssociates Degree in accounting is preferred, but not required.Special Requirements:Must be able to reconcile insurance billing accounts; Must be proficient with Spreadsheets; Must possess and maintain a valid Arizona Driver's License; Must have a current Level 1 Arizona Clearance Card. Failure to maintain a current Level 1 Clearance Card will result in termination.The Pascua Yaqui Tribe provides 22 days of Paid Time Off which increases with years of service and 15 paid Holidays per year. We offer a comprehensive healthcare benefit package that surpasses or rivals the biggest organizations in Tucson. We encourage you to stay healthy by providing an onsite Wellness Center. Additionally, the Tribe offers a 401(k) Plan with a generous match in which you're immediately vested along with a profit sharing plan after one year of employment. Sworn police and and fire employees are eligible to make Pre-Tax and After-Tax contirbutions to the Arizona Public Safety Personnel Retirement Systems ("PSPRS").01Do you have a High School Diploma or G.E.D?NoYes02Do you have three (3) year of work experience with Medical Billing and/or Coding; and experience sufficient to successfully perform the essential duties of the job such as those listed above?YesNo03Do you have experience reconciling insurance billing accounts?YesNo04Are you proficient in using spreadsheets?YesNo05Do you have a current valid Arizona Driver's license?YesNo06Do you currently have a valid Level 1 Arizona Clearance Card, or are you able to obtain one within ninety (90) days of hire? (Please note: failure to maintain a current Level 1 Clearance Card will result in termination.)YesNo Required Question