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 Shift
Time Type:
Full time
Department:
CC807100 PSO Professional BillingMonday to Friday, 8:00 a.m. to 5:00 p.m. — Hybrid
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.
High school diploma or GED or equivalent
Bachelor's degree in a related field of study.
High School Diploma/GED, or 2 years of experience in lieu of a diploma/GED.
1. 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.
Arkansas Children's is the only healthcare system in the state solely dedicated to caring for Arkansas' more than 700,000 children. The private, non-profit organization includes two pediatric hospitals, a pediatric research institute and USDA nutrition center, a philanthropic foundation, a nursery alliance, statewide clinics, and many education and outreach programs — all focused on fulfilling a promise to define and deliver unprecedented child health. Arkansas Children’s Hospital (ACH) is a 336-bed, Magnet-recognized facility in Little Rock operating the state’s only Level I pediatric trauma center; the state's only burn center; the state's only Level IV neonatal intensive care unit; the state's only pediatric intensive care unit; the state’s only pediatric surgery program with Level 1 verification from the American College of Surgeons (ACS); the state’s only magnetoencephalography (MEG) system for neurosurgical planning and cutting-edge research; and the state's only nationally recognized pediatric transport program. Arkansas Children’s Hospital is nationally ranked by U.S. News & World Report in seven pediatric specialties (2022—2023): Cancer, Cardiology & Heart Surgery, Diabetes & Endocrinology, Nephrology, Neurology & Neurosurgery, Pulmonology and Urology. Arkansas Children’s Northwest (ACNW), the first and only pediatric hospital in the Northwest Arkansas region, is a level IV pediatric trauma center. ACNW operates a 24-bed inpatient unit; a surgical unit with five operating rooms; outpatient clinics offering over 20 subspecialties; diagnostic services; imaging capabilities; occupational therapy services; and Northwest Arkansas' only pediatric emergency department, equipped with 30 exam rooms. Generous philanthropic and volunteer engagement has sustained Arkansas Children's since it began as an orphanage in 1912, and today ensures the system can deliver on its promise of unprecedented child health. To learn more, visit archildrens.org.
