Dermatology Insurance A/R Biller and Coder - Remote Arizona Center for Cancer Care - 3.1 Phoenix, AZ Job Details Full-time 2 hours ago Qualifications Health insurance authorizations Appeals Accounts receivable optimization Health insurance co-pays HIPAA compliance Medicare Safety protocol adherence Accounts receivable management Overseeing healthcare denial management CMS Regulatory compliance in claims processing Practice management software Medical billing and coding coordination with healthcare providers HIPAA Patient management software Mid-level CMS regulatory compliance Driver's License Charge capture (medical billing) Debt collection payment plan Medical denial root cause analysis (RCA) Medical insurance appeals management Centers for Medicare & Medicaid Services (CMS) billing regulations Medical claims submission Medicaid Medical billing account reconciliation Billing issue inquiries Handling patient inquiries Payment reconciliation Root cause analysis Full Job Description Job Summary The dermatology insurance A/R biller and coder at Arizona Center for Cancer Care (AZCCC) is responsible for translating clinical documentation into accurate billing codes and managing the revenue cycle from claims submission through payment collection. This role reports to the Dermatology Billing Lead and works closely with them and fellow team members to ensure accurate charge capture, timely and clean claims submission, effective denial resolution, and healthy accounts receivable performance. This role may be performed remotely or in-office. Duties and responsibilities Reviews provider documentation to assign accurate CPT and ICD-10 codes for visit types ranging from routine skin checks to biopsies, excisions, Mohs micrographic surgery, cryotherapy, and cosmetic procedures. Applies correct modifiers to reflect multiple procedures performed in a single visit, in accordance with payer and coding guidelines. Query providers for clarification when documentation is incomplete or does not support the code being billed. Prepares and submit clean claims to insurance payers (commercial, Medicare, Medicaid) via clearinghouse in a timely manner. Verifies that claims include all required documentation, prior authorizations, and referral information prior to submission. Distinguish cosmetic (self-pay/non-covered) procedures from medically necessary ones to ensure proper billing pathway. Monitors outstanding claims and follow up on unpaid or aged accounts according to A/R aging reports. Investigates and resolve claim denials, rejections, and underpayments; resubmit corrected claims and file appeals with supporting documentation as needed. Post payments, adjustments, and write-offs accurately in the practice management system, and reconcile insurance payments against contracted fee schedules. Identifies root causes of denials and escalate recurring trends to the Billing Lead, partnering with front office/scheduling staff to help prevent repeat issues (e.g., missing referrals, expired authorizations). Generates patient statements for balances after insurance adjudication (copays, coinsurance, deductibles, non-covered cosmetic services). Responds to patient billing inquiries and set up payment plans as needed, escalating complex issues to the Billing Lead. Maintains audit-ready documentation for all coding decisions and support internal or external billing audits as needed. Maintains compliance with HIPAA, payer guidelines, and CMS regulations in all billing and coding activity. Tracks and report daily/weekly work completed per practice tracking procedures. Performs other duties as assigned by management. Direct reports N/A EEO Statement Arizona Center for Cancer Care 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. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training. Licensure and Certifications N/A Working conditions Works onsite in an office or clinical setting; remote or hybrid work may be permitted based on business needs and in accordance with Arizona Center for Cancer Care's Remote Work Policy. Emphasizes collaboration with various stakeholders. Necessitates effective communication and teamwork. Functions in a fast-paced environment. May require flexibility in working hours. Requires adherence to safety protocols and compliance with healthcare regulations. Valid driver's license and reliable transportation for travel between locations. Physical requirements Must be able to lift 25 lbs. Must be able to sit, stand, and walk for extended periods of time. Must be able to bend, kneel, crawl, and twist as needed. Must be able to see, hear, type, and speak. Must be able to reach and pull.