ARKANSAS CHILDREN'S IS A TOBACCO FREE WORKPLACE. FLU VACCINES ARE REQUIRED. ARKANSAS CHILDREN'S IS AN EQUAL OPPORTUNITY EMPLOYER. ALL QUALIFIED APPLICANTS WILL RECEIVE CONSIDERATION FOR EMPLOYMENT WITHOUT REGARD TO RACE, COLOR, RELIGION, SEX, SEXUAL ORIENTATION, GENDER IDENTITY OR EXPRESSION, NATIONAL ORIGIN, AGE, DISABILITY, PROTECTED VETERAN STATUS OR ANY OTHER CHARACTERISTIC PROTECTED BY FEDERAL, STATE, OR LOCAL LAWS.
This position has been designated as safety sensitive and cannot be filled by a candidate who is a current user of medical marijuana.CURRENT EMPLOYEES: Please apply via the internal career site by logging into your Workday Account (https://www.myworkday.com/archildrens/)and search the "Find Jobs" report.
Work Shift:
Day ShiftTime Type:
Full timeDepartment:
CC807100 PSO Professional BillingSummary:Monday to Friday, 8:00 a.m. to 5:00 p.m. — HybridAdditional Information:Prepares accurate and complete medical claims/billings for timely submission to third-party payers. Responsible for follow-up and collection activities to assure prompt and proper payment from third-party payers. Responsible for knowledge of medical billing requirements and software products essential to performing job duties. Analyzes claims for payment. Resolves denials. Identifies problem trends and works to resolve.
Required Education:High school diploma or GED or equivalentRecommended Education:Bachelor's degree in a related field of study.Required Work Experience:High School Diploma/GED, or 2 years of experience in lieu of a diploma/GED.Recommended Work Experience:Required Certifications:Recommended Certifications:Description1. Analyzes medical claims to assure they are complete and accurate and have any required attachments before being filed to payer (clean claim).
2. Expedites proper adjudication of claims by payer to maximize reimbursement and minimize older age accounts. Identifies claims that have not been adjudicated and assures they are adjudicated promptly. Analyzes reason given for claim not being adjudicated and how we might overcome lack of adjudication.
3. Reviews adjudicated claims to assure they were properly adjudicated with the proper payment amount and to assure that unpaid amounts are valid and properly categorized. Appeals claims that are improperly adjudicated so they are promptly corrected.
4. Identifies problems and patterns, quantifies, reports and resolves problems.
5. Establishes effective working relationships with internal and external customers to expedite creation of clean claims and prompt and proper adjudication of claims. Communicates technical information accurately and effectively whether in writing or orally. Excellent ability to think on feet.
6. Performs other duties as assigned.
Skills Required
- High school diploma or GED or equivalent
- Two years of experience may substitute for diploma/GED
- Knowledge of medical billing requirements and billing software
- Experience preparing, analyzing, and appealing medical claims and resolving denials
- Strong written and oral communication skills
- Flu vaccination (required by employer)
- Not a current user of medical marijuana (position safety sensitive)
What We Do
Arkansas Children's, Inc. is the only healthcare system in Arkansas solely dedicated to caring for children. The organization includes two hospitals, a research institute, and a non-profit foundation. It provides specialized pediatric care, including a Level 1 Trauma Center and neonatal intensive care, with a mission to champion children by making them better today and healthier tomorrow through comprehensive medical services and outreach programs.
