Claims Support Specialist
Job Description
Job Description
Top Job
Located in Phoenix, AZ OverviewWe are seeking a detail-oriented and driven Behavioral Health Claims Specialist / Medical Biller to join our team. This role supports the day-to-day operations of the claims department by gathering information, processing high-volume behavioral health and psychiatric healthcare claims, and ensuring accurate and timely reimbursement. The ideal candidate is highly skilled in Medicaid AHCCCS Plans, thrives in a fast-paced environment, and is passionate about maximizing collections while maintaining compliance and accuracy. What You'll Do
- Verify insurance eligibility for behavioral health services.
- Scrub, batch, and file claims for accuracy, completeness, and compliance.
- Reconcile electronic 837 transactions, payment files, and ensure claims are worked through to completion.
- Troubleshoot denied or delayed claims with payers; analyze, research, and resubmit as needed.
- Post payments and reconcile accounts to ensure accuracy.
- Regularly correspond with insurance companies regarding outstanding or denied claims.
- Maintain strict confidentiality of all claims and participant information.
- Collaborate with internal teams to ensure proper documentation, coding, and billing practices.
- Work toward and consistently achieve monthly collection goals.
- High School Diploma or equivalent required; Associate's degree in Medical Billing & Coding, CPC certification, or equivalent experience strongly preferred.
- Minimum of 1-2 years' experience in a healthcare claims or billing setting, with behavioral health experience preferred.
- Proven experience with Medicaid AHCCCS Plans and high-volume claims processing.
- Proficiency in Microsoft Excel (assessment required).
- Experience with EHR and computerized billing functions; Credible Billing Software experience a plus.
- Familiarity with electronic billing systems (837 transactions) and payment reconciliation.
- Valid Driver's License and acceptable three-year Motor Vehicle Record.
- Valid Fingerprint Clearance Card or ability to obtain within 90 days of hire.
- Not ideal for candidates with primarily manual entry billing backgrounds.
- Strong problem-solving skills and persistence in pursuing payment.
- Highly organized with excellent attention to detail.
- Effective communicator with both internal staff and insurance representatives.
- Ability to work independently while thriving in a high-volume, fast-paced environment.
- Passion for getting payments collected and driving results.
- Exceptionally generous PTO (3.5 weeks off your first year and rising in subsequent years)
- 14 paid holidays
- 403(b) with company match
- Medical/Dental/Vision insurance
- Voluntary short and long term disability insurance
- Life insurance
- Employee assistance program
- Voluntary insurance for critical illness, accident and hospitalization
- Pet insurance
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