Business Office Specialist I

Marana Main Health Center, Marana, Arizona, United States of America

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Job Description

Posted Tuesday, September 3, 2024 at 9 : 00 AM

MHC Healthcare is seeking a Business Office Specialist to join our Central Business Office team at the MHC Marana Main Health Center, located in the heart of Marana, AZ.

The Business Office Specialist provides follow-up on all non-paid claims and maintains accurate patient account records. MHC Healthcare is a Federally Qualified Community Health Center (FQHC), with 17 sites in Tucson and Pima County.

MHC Healthcare is building a world-class integrated health care system that is committed to caring for special populations and focused on improving health outcomes for our patients.

This position may be filled as a Business Office Specialist I or II, depending on qualifications.

The following qualifications are required :

• High school diploma or equivalent
• 1 year experience in a medical or behavioral health billing setting or completion of billing or coding program

The following qualifications are preferred :

Direct coding experience

Equivalent combination of education and experience may be considered if applicable and must be directly related to the functions and body of knowledge required to successfully perform the job.

This position has the following supervisory responsibility :

Does not direct or supervise others.

The ideal candidate will also possess the following knowledge, skills, and abilities :

• Computer proficient
• General knowledge of medical terminology
• Knowledge of ICD-10 and CPT codes
• Ability to participate in a teamwork approach to accomplish tasks
• Calculator by touch
• Effective interpersonal and telephone communication skills
• Ability to work independently
• Excellent customer service, organizational, and communication skills with emphasis on responsiveness, building trust, mutual respect, and courtesy

Duties and Responsibilities :

• Ensures encounters are entered into the billing system within 24 business hours of completed office visit and chart completions.
• Performs follow-up duties to collect payment in full on all accounts.
• Initiates account adjustments as appropriate.
• Works all claims denials according to established procedures.
• Files appeals for payment on accounts as necessary.
• Utilizes the billing system to access accounts needing follow-up, including hold boxes.
• Prints denials and A / R reports to guide follow-up activities.
• Contacts insurance plans as needed, by phone, fax, or online.
• Re-files corrected insurance claims as necessary.
• Notes on accounts all actions taken.
• Sends secondary insurance claims electronically when needed.
• Seeks clarification from the Business Office Manager for insurance, payment, or adjustment issues.
• Posts adjustments once approved by Director of Billing and Coding and / or CFO.
• Notifies the Manager of Billing and Coding when training issues are discovered.
• Performs appropriate follow-through from start to finish in accordance with assigned tasks.
• Maintains proper billing standards in accordance with third-party payors.
• Maintains professional and technical knowledge by attending educational workshops.
• Performs all other related duties as assigned or requested.

As an employee of MHC Healthcare, we share in a very strong mission : Dedication to providing Service Excellence in Promoting Health and Well Being.

To support this mission in our community, MHC Healthcare believes it must start at home. Therefore, employees have many opportunities to care for our health and wellness with benefits such as :

• Medical, Dental, and Vision
• 403(b) with employer contribution
• Short-term disability and other benefits
• Paid time off including 11 holidays plus vacation and sick leave accrual
• Paid bereavement, jury duty, and community service time
• Employee discount for medical services ($500 per year for full-time)
• Education reimbursement ($3,000 per year for full-time)

MHC Healthcare will recruit, hire, train, and promote persons in all job titles without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.

In addition, all personnel actions such as compensation, promotion, demotion, benefits, transfers, staff reductions, terminations, reinstatement and rehire, company-sponsored training, education and tuition assistance, and social and recreational programs will be administered in accordance with the principles of equal employment opportunity.

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