AHCCCS Billing/Coding/Credentialing Specialist

Job Description

Job Description

The Billing/Coding/Credentialing Specialist possesses medical billing knowledge and understanding in order to monitor and manage accounts, claims, claims resolution, accounts receivable, and posting of AHCCCS claims. This position must follow-up on outstanding accounts by monitoring and executing various billing functions. Various Financial and Productivity reports will be submitted daily, weekly, to various departments. This is not a remote position. This position is a PT/FT position (24-32 hours weekly).

Note: Applicants must demonstrate understanding of AHCCCS billing processes and terminology as well as other types of insurances. In addition applicants must be able to demonstrate ability to properly process and submit claims and reconcile denials. Applicants must have experience completing the insurance credentialing process.

Duties:

• Submit billing in a timely manner daily to AHCCCS insurances through various portals.

• Create reports on billing levels on a weekly basis.

• Assists with physical site upkeep. (Cleaning, sanitizing, emptying trash, vacuuming etc.)

• Keep track and process accounts and incoming payments in compliance with financial policies and procedures. Send daily / weekly reports to CEO

• Perform day to day financial transactions including verifying, classifying, computing, posting and recording accounts receivable data.

• Verify discrepancies and resolve client’s billing issues and reconcile all payments received from insurance companies and with the services provided.

• Work in multiple software systems to accomplish AR results.

• Generate financial statements and reports detaining accounts receivable status.

• Serve as the liaison to therapist and AHCCCS Prior Authorization Department

• Tracking and organizing insurance information, following up on all claim denials.

• Effectively communicating billing, insurance, and coverage criteria updates with staff and management.

• Understanding of the insurance credentialing process.

• Keep up with compliance, coverage criteria, ICD-10 information and update supervisors and team as needed.

• Assists with general office cleaning and maintaining the conference room area and other areas of the office.

• *Other duties as assigned.

Requirements:

• High School Diploma or GED

• Must Have Minimum of 2 to 3 years’ experience in Medical Billing, Billing and Coding Credential is required in addition to experience billing AHCCCS AIHP, AZ Complete, UHC/Optum, Blue Cross Blue Shield and other insurances. Applicant must be able to demonstrate competency with these Insurances plans and the claims processes.

• Confidentiality of Protected Health Information.

• Proven ability to calculate post and manage accounting figures and financial records.

• Data entry skills and knowledgeable in arithmetic and statistics.

• Excellent verbal and written communication skills. Proficiency in English and Spanish preferred.

• Customer service orientation and negotiation skills.

• High degree of accuracy and attention to detail

• Bachelors degree in Finance preferred. Some academic training in accounting required.

Must have a Valid Arizona Driver License, Proof of Valid Insurance, Current Level 1 AZDPS Finger Print Clearance Card, CPR and First Aid Certification, Recent Negative TB Test and maintain these items during employment.

This is an in-person position only, no remote options.