What are the responsibilities and job description for the Full Cycle Biller position at Spooner?
**This is not a remote position**
At Spooner, Arizona's largest physical therapy private practice, we are most proud of our culture of excellence that is founded on our core values. Spooner has been helping our communities achieve health through movement for over 30 years, and we continue to grow in size and expertise every year. If you are looking to join a company where you can build a career, Spooner is the place for you.
Are you an outgoing and engaging individual committed to delivering exceptional customer service? Are you a natural communicator who enjoys communicating with diverse people? We encourage you to apply if you are ready to be at the forefront of customer service excellence!
As the Medical Billing and Collections Specialist, you will serve as the communications hub between the company, patients, referring providers and payers. You will be responsible for analyzing claim denials, billing/collecting payments, and reviewing patient statements for accuracy. This role is vital in ensuring our clients and stakeholders receive the best possible experience.
Healthcare & Benefits
Spooners award-winning healthcare and benefits plan is dedicated to ensuring our employees have access to health care and receive the right care, at the right time with the right provider. Spooner employees enjoy no cost expert physical therapy, hand therapy and access to a direct primary care team dedicated to keeping our team healthy.
- Student loan repayment program
- $500 individual and $1,000 family deductibles
- Low premiums
- A dedicated direct primary care medical team for Spooner employees
- Dental, vision, life, and other voluntary insurances
- Paid time off and holiday pay
- 401(k) matching
- Employee Assistance Program
- Many other benefits to help keep you happy and healthy
What Youll Be Doing
- Provide a communication hub to and from the company, patients, clinic teams, referring providers, clearing house, and payers regarding benefit eligibility, payments, and denials (including authorization guidelines).
- Accurately verify benefits and eligibility to ensure that our patients can make informed decisions in regard to the cost associated with their healthcare plan, while documenting eligibility and benefits within our systems.
- Successfully schedule our patients with the goal of exceeding their expectations timely, conveniently, and with the right provider or specialist.
- Answer inbound calls in order of when they are received.
- Create and maintain multiple scheduling logs such as daily call volume, unscheduled cases, call attempts completed, daily verification log, etc.
- Obtain prior authorization for new patients/initial authorizations scheduled by Central Client Services.
- Re-verification of benefits for all active Spooner patients on a standard schedule.
- Run daily verification reports.
- Process all charge entry and claims submission functions, including coding and managing rejections.
- Review status of patient accounts to identify and resolve billing and processing problems in a timely manner.
- Resolve edits related to coding; obtain and review relevant documentation and ensure documentation supports services billed.
- Review patient statements for accuracy and completeness and obtain any missing information.
- Review and analyzing claim denials in order to perform the appropriate resolution, rebilling, and/or appeals steps.
- Receive insurance correspondences, such Explanation of Benefits (EOB) and research appropriate claims steps, such as first or second appeal.
- Communicate daily with insurance carriers to track and check status of appeals.
- Research reasons of denial from first appeal and incorporate more in-depth rebuttals for second appeals.
- Prepare an analytical summary report identifying areas of concern by dollar amount, volume and new denials.
- Resolve tasks assigned to you and to billing.
What You Can Expect
- A team environment that fosters continuous learning and fun.
- A 6 month onboarding program.
What You Bring to the Role
- Minimum high school diploma or GED
- Minimum of 2-3 years experience working in a medical field
- Medicaid Billing experience preferred
- Excellent customer service and communication skills
- Must sign up for ID.me within 30 days of hire
About Spooner
Spooner is a place for professionals with a growth mindset who want to push themselves to achieve excellence. Spooner began with a vision of disrupting the status quo of healthcare, and to accelerate the use of physical and occupational therapists as primary care, musculoskeletal experts. Spooner continues to grow in the greater-Phoenix area and has recently entered the Dallas-Fort Worth market. If you are interested in joining us on our journey of growth, collaboration, and disruption, you wont be disappointed!
This is not your common workplace. Fun and excellence go hand and hand at Spooner, and we provide ample opportunities to achieve both. Our commitment to continuous learning is evident in our culture-first environment, and we are always looking for team members to strengthen and cultivate it!
We promise to help you achieve excellence. We will help you become a leader. We will help you accelerate your career.
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