Medical Biller

Position Overview

We are seeking an experienced, detail-oriented, and highly motivated Medical Biller to join our growing behavioral health organization. The ideal candidate will possess extensive knowledge of AHCCCS billing requirements and demonstrate proven experience managing claims for both facility-based services and group provider payment arrangements.

In this role, you will oversee the full revenue cycle process, including claim submission, payment posting, denial management, accounts receivable follow-up, and compliance monitoring. Your expertise will directly support the financial success of the organization while ensuring billing accuracy, regulatory compliance, and timely reimbursement for services provided.

This position is ideal for a billing professional who thrives in a fast-paced healthcare environment and is committed to maintaining excellence in revenue cycle operations.

Key ResponsibilitiesRevenue Cycle Management

• Manage the complete medical billing process from claim creation through final payment resolution.
• Submit electronic claims accurately and timely through EMR/EHR systems and payer portals.
• Process claims under both Facility Provider IDs (Clinic Billing) and Group Provider Payment IDs.
• Verify member eligibility, benefits, authorizations, and payer requirements prior to claim submission.
• Review billing documentation to ensure compliance with payer and regulatory requirements.

Claims Processing & Follow-Up

• Review and interpret clinical documentation, diagnoses, procedures, and treatment records to ensure accurate billing.
• Assign and validate appropriate CPT, HCPCS, ICD-10, and other applicable billing codes.
• Monitor claim status and perform timely follow-up on unpaid, rejected, or denied claims.
• Investigate claim denials and implement corrective actions to maximize reimbursement.
• Submit corrected claims, appeals, and reconsideration requests as needed.

Accounts Receivable & Collections

• Monitor aging reports and accounts receivable balances.
• Reconcile payments, remittance advices, and electronic funds transfers (EFTs).
• Ensure accurate payment posting and adjustment processing.
• Work proactively to reduce outstanding balances and improve collection rates.

Compliance & Quality Assurance

• Maintain compliance with AHCCCS regulations, payer billing requirements, HIPAA standards, and applicable state and federal guidelines.
• Stay informed regarding coding updates, reimbursement changes, and billing regulations.
• Assist with internal audits, AHCCCS audits, and payer reviews.
• Maintain organized records of billing activities, correspondence, and claim resolutions.

Collaboration

• Work closely with providers, clinicians, case managers, and administrative staff to resolve documentation and billing discrepancies.
• Communicate effectively with insurance carriers, managed care organizations, and government payers regarding claim status and reimbursement issues.
• Provide recommendations to improve billing workflows and increase revenue cycle efficiency.

Required Qualifications

• Minimum of 2 years of medical billing experience, preferably in behavioral health, substance use treatment, or outpatient healthcare settings.
• Demonstrated experience billing AHCCCS claims.
• Experience billing both:
• Facility Provider IDs (Clinic Billing)
• Group Provider Payment IDs
• Strong understanding of:
• CPT Coding
• HCPCS Coding
• ICD-10 Coding
• Medical Terminology
• Insurance Verification
• Claims Submission and Adjudication
• Experience using EMR/EHR systems and electronic billing platforms.
• Knowledge of accounts receivable management and denial resolution processes.
• Strong analytical, organizational, and problem-solving skills.
• Excellent written and verbal communication abilities.
• Ability to work independently while managing multiple priorities and deadlines.

Preferred Qualifications

• Experience within behavioral health, substance use treatment, outpatient treatment centers, counseling services, peer support services, or case management programs.
• Familiarity with Arizona AHCCCS health plans, RBHAs, and managed care organizations.
• Knowledge of ADHS licensing and documentation requirements.
• Certified Professional Biller (CPB), Certified Coding Specialist (CCS), or equivalent certification preferred.

What We Offer

• Competitive compensation based on experience.
• Professional growth and development opportunities.
• Collaborative and supportive work environment.
• Opportunity to contribute to an organization dedicated to improving behavioral health outcomes.
• Meaningful work that directly supports access to quality healthcare services.

Equal Opportunity Employer

We are committed to creating an inclusive workplace and are proud to be an Equal Opportunity Employer. Qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, disability, veteran status, or any other protected status.

Pay: $60,000.00 - $72,000.00 per year

Benefits:

• Flexible schedule

Work Location: In person

Salary : $60,000 - $72,000