**Work Shift:** Day Shift **Time Type:** Full time **Department:** CC017090 Patient Financial Services **Summary:** Monday - Friday, 8:00 a.m. - 5:00 p.m. — Hybrid (On-site as needed) 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. **Additional Information:** **Monday - Friday, 8:00 a.m. - 5:00 p.m. — Hybrid (On-site as needed)** **\#AC2024** **Required Education:** Bachelors Degree or Equivalent Experience **Recommended Education:** **Required Work Experience:** Related Field - No experience required **Recommended Work Experience:** Administrative Support - Direct_Epic experience **Required Certifications:** **Recommended Certifications:** **Description** 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 (https://www.archildrens.org/about-us) is the only hospital system in the state dedicated to caring for children, which enables us to uniquely shape the landscape of pediatric care in Arkansas. Arkansas Children’s is driven by four core values—safety, teamwork, compassion and excellence—which inform every action. Arkansas Children’s Hospital has received Magnet Status (https://www.archildrens.org/about-us/magnet-recognition) from the American Nurses Credentialing Center (ANCC), for nursing excellence and patient outcomes. And we are nationally ranked by U.S. News & World Report (https://www.archildrens.org/about-us/awards-and-recognition) for Cancer, Cardiology & Heart Surgery, Diabetes & Endocrinology, Nephrology, Neurology & Neurosurgery, Pulmonology & Lung Surgery and Urology. For more than a century, Arkansas Children’s has met the unique needs of children. But we’re more than just a hospital treating sick kids—our services include two hospitals, a pediatric research institute, foundation, clinics, education and outreach, all with an unyielding commitment to making children better today and healthier tomorrow. Arkansas Children’s Little Rock campus includes a 336-bed hospital with the state’s only pediatric Level 1 Trauma Center, burn center, Level 4 neonatal intensive care and pediatric intensive care, as well as a nationally-recognized transport service. And Arkansas Children’s Northwest (https://www.archildrens.org/locations/arkansas-childrens-nw) provides inpatient and emergency care, clinic rooms and diagnostic services to children in that corner of the state. _“Arkansas Children’s is a place of hope and comfort for children and parents. When you are at children’s, you are part of an elite team united with a common goal of saving children and making their lives better.”_ Michael – Business Operations Manager “Arkansas Children’s Hospital is a prestigious institution that cares for children.” Linda – Information Systems Analyst “We are an organization of care, love, and hope while we champion children.” Angela – Parking and Fleet Coordinator “Care, love, and hope for children!” Kathy – Administrative Assistant “When I think of my time here at Arkansas Children’s Hospital, I can honestly say that it has given me a unique perspective on the human condition, and the various roles that we all have in patient care. As a supply assistant, I have a very important job ensuring that the doctors and nurses have what they need to provide the world class medical care to the Children of Arkansas and surrounding states. Being a Champion for Children is more than a catch phrase, it is a way of life!” Nick – Supply Assistant Arkansas Children's provides equal employment opportunity to all persons without regard to age, race, color, religion, national origin or citizenship status, disability, military status, sexual orientation, gender identity or expression, pregnancy or any other category protected by federal, state and local laws. Further, Arkansas Children's will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant.