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 clients 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.

*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.