Follow Up & Collections - Billing Specialist IV - Non NSA

PHI Health is looking for dynamic, driven individuals to join our team. Our mission is to provide top‑tier emergency medical services with unmatched speed and efficiency, saving lives when every second counts.Sign‑on bonus up to $7,500.Who We ArePHI Health is the leading air ambulance provider in the United States. With an unmatched safety record and a team of aviation, medical and communication specialists, we set the standard in the air medical industry. We transport more than 22,000 patients each year from over 80 bases across the country, while providing outreach education to local communities and leading healthcare systems.Job SummaryUnder the direction and supervision of the Team Operational Coordinator (TOC), the Follow Up & Collections III position performs all collection tasks utilizing high‑level knowledge, skills, abilities and experience. The role manages patient accounts from re‑submission through final resolution, addresses denials through appeal letters, and ensures account balances are correct based on payer contract terms.ResponsibilitiesActs as a patient advocate to obtain additional information and support for claims processing or to discuss outstanding patient balance with resolution options.Analyzes adverse billing, collections and payer trends and reports findings to management, including suggested solutions.Assists with special projects related to payer issues or overall collections shortfalls.Contacts insurance companies in an assertive and knowledgeable manner to obtain timely payments, including escalation to supervisors or grievance departments.Categorizes and quantifies payer payment issues for resolution and reporting to management.Demonstrates and maintains consistent customer focus in the face of adversity and change, both internally and externally.Understands payer fee schedules, enrollment requirements and PHI payer/facility contracts.Performs insurance collections including payment negotiations, overpayment reviews, approvals, next actions on correspondence, insurance types and classes in compliance with PHI billing policies and procedures.Drafts correspondence to patients and payers, including first‑level appeals for technical denials, and identifies accounts to refer to the Appeals Department for escalation.Handles patient calls related to collections activities, including financial review for the charity program, payment plans, negotiation of discounts and resolution of patient complaints.Maintains professional relationships and communicates effectively with first responders, facilities, PHI agencies, insurers, attorneys and patients.Demonstrates positive teamwork and effective cooperation within the established team and throughout the entire PFS department.Organizes and prioritizes work to support production goals using online tools, required systems and software.Participates in increasing responsibility through ongoing training and expansion of duties.Performs financial screening for payment negotiations, payment plans and the charity program, in compliance with PHI billing policies and procedures.Conducts in‑depth account reviews such as skip‑tracing, correspondence research, secondary claims billing, payment review, contractual adjustments and insurance information updates, in compliance with PHI billing policies.Collects and confirms insurance coverage, including obtaining prior authorization, third‑party liability and coordinator of benefits.Maintains knowledge of HCPCS, CPT, ICD‑9 and ICD‑10 codes, medical terminology and clinical documentation.Provides leadership and acts as a resource for management, training and support for the PFS Billing Staff.Researches, evaluates and communicates payer‑specific billing policies, guidelines and statutory regulations for insurance and collection follow‑up.Monitors and tracks claims and correspondence, prioritizing work to maintain production standards.Reviews and evaluates patient accounts for appropriate handling, regardless of age, status or payer.Interprets explanation of benefits to determine contractual compliance, accuracy of payment received, patient responsibility, denial status or service coverage reduction, and follows up appropriately.Takes direction, coordinates projects and prioritizes assignments on an individual basis, as well as on a departmental/team level.Participates in ensuring claims are accurate prior to submission; trains staff on billing requirements for new and established payers.Ensures compliance with insurance regulations and guidelines, including CMS guidelines, when discussing outstanding claims with payers related to slow payments, underpayments or denials.Complies with company HS&E policy and procedures and supports Safety Management System activities.Provides visible support of Destination Zero.Other duties and responsibilities as assigned.Schedule/LocationPhoenix, AZ5 & 2The Successful Candidate Will HaveHigh school diploma (or GED equivalent) with prior experience in medical billing/collections and progressive responsibilities.Knowledge of general office procedures using office equipment.Proficient PC skills, including Microsoft Office Word, Excel and medical billing software.Experience with email and web usage.Some college preferred.Ability to pass a pre‑placement drug test and background screen.Designated Safety Sensitive for purposes of the Arizona Medical Marijuana Act.Compensation and BenefitsRegular pay scale applies.Our Core CompetenciesSafe – absolute belief in the tenets of Destination Zero.Efficient – focus on outcomes that maximize productivity and sustainability.Quality – commitment to excellent performance producing reliable outcomes.Service – dedication to serving customers, communities and each other.Behavioral CompetenciesDrive & Energy – maintain a fast pace and continue to produce during exhausting circumstances.Functional & Technical Expertise – add organizational value through unique expertise and serve as a resource.High Standards – foster continuous improvement and adoption of best practices.Initiative – take proactive action without prompting.Integrity – act ethically and honestly, applying standards to daily work activities.The PHI Health AdvantageFor more than 40 years, PHI Health has provided critical air medical transport services nationwide, equipping each aircraft with advanced technology and subjecting crews to rigorous protocols and training. Our accident rate remains well below the national average, and we were the first to receive the Vision Zero Aviation Safety Award, underscoring our commitment to safety.DisclaimerThe above Statements describe the general nature and level of work performed by people assigned to this classification and are not exhaustive.PHI, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.#J-18808-Ljbffr