AHCCCS BillingCodingCredentialing Specialist

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.

Duties:

• Submit billing in a timely manner daily to AHCCCS through the portal.

• 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 all employees as needed.

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

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* Other duties as assigned.

Requirements:

• High School Diploma or GED

• 1 to 3 years’ experience in Medical Billing, Billing and Coding Certificate required in addition to experience billing AHCCCS AIHP, AZ Complete, UHC/Optum, Blue Cross Blue Shield and other insurances.

• 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

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

Must have a Valid Arizona Driver License, Current Level 1 AZDPS Finger Print Clearance Card, CPR and First Aid Certification

Recent Negative TB Test. This is an in-person position only, no remote options.