2 Billing Processor Jobs in Tucson, AZ
CODAC Health Recovery Wellness is Hiring a Billing Processor Near Tucson, AZ
Essential Duties and Responsibilities (Billing Processor I, II and CPC):
- Verifies member coverage, benefits and services allowed for Medicare, Commercial and AHCCCS payors.
- Confirms health insurance coverage for coordination of benefits to process claims
- Works with payors to request and resolve Prior Authorizations discrepancies.
- Resolves rejected and denied billing errors.
- Applies provider contract provisions to determine if claim is payable or denied.
- Determines if denied claims related to rendering provider, service location, coordination of benefits, refunds or adjustments.
- Reviews medical and behavioral claims, post payment or denial codes within established department guidelines and standards
- Maintain records, files, and documentation as appropriate
- Maintains billing, explanation of benefits, and Receipts filing system and records retention.
- Runs denials and cash receipts reports.
- Posts receipts and Explanation of Benefits (EOB) via manual posting.
- Routinely monitors and ensures eligibility segments are documented correctly in NextGen.
- Meet department production and quality standards
- Performs other related duties in accordance with agency growth and changes.
- Reviews and processes inbound 835 electronic response files (ERAs) for the assigned Medicaid payer.
- Reviews and resolves claim discrepancies and errors prior to posting the assigned Medicaid ERA.
- Responsible to communicate and resolve any posting errors with NextGen directly.
- Assigns denied and rejected billing claims to their Medicaid team members.
- Prepares and reports payor payment trends for the assigned Medicaid payer.
- Point of contact for communicating directly with the Medicaid provider representative.
- Point person to communicate and resolve denials and rejections for the assigned Medicaid payer.
- Reconciles Medicaid payer monthly payments to EFTs and communicates discrepancies to the supervisor.
- Assists billing team members with denied and pended billing errors.
- Assists with training specific to the assigned Medicaid payer.
- Answer calls and emails related to coding.
- Review denial notes to determine correctness in diagnosis, modifier & CPT code Assist providers in selecting correct CPT codes
- Assist Data Validation Audits
- 3 years billing & claims processing experience
- A minimum of 5 years billing & claims experience AND;
- A minimum of 1 year processing claims as assigned to the primary Medicaid ERA funder
- Active AAPC Certification
- Certified Coder, preferred
- Valid Arizona Drivers license, proof of current insurance and willingness to use personal vehicle.
- Clean Motor Vehicle Record - no more than 2 moving violations or a license suspension in past 3 years.
- Bilingual a plus.
- Ability to interact effectively with other service providers.
- Intermediate to advanced computer skills using MS Office products, Word, Excel, Access, etc., importing/exporting data to/from applications.
- Ability to communicate effectively both orally and in writing
Job Summary
Full Time
Ambulatory Healthcare Services
$41k-54k (estimate)
06/04/2024
06/30/2024
codac.org
TUCSON, AZ
200 - 500
1970
ZACK KNECKERBOCKER
$10M - $50M
Ambulatory Healthcare Services
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About CODAC Health Recovery Wellness
CODAC provides a full continuum of integrated care for adults living with mental illness, substance use disorders, and trauma in Pima County, Arizona. CODAC's primary care providers, psychiatrists, nurses, medical assistants, therapists, case managers, peer support specialists, and other wellness providers work together to treat the whole person all in one convenient location. CODAC has multiple locations, same-day intakes and offers services in-person and via telephone or video conferencing. Through 8 service locations and over 300 staff and volunteers, CODAC serves more than 15,000 individua...ls and families each year. CODAC is a nonprofit 501(C)(3) organization.
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The job skills required for Billing Processor include Billing, Accounting, Communicates Effectively, CPT, etc. Having related job skills and expertise will give you an advantage when applying to be a Billing Processor. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Billing Processor. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Billing Processor positions, which can be used as a reference in future career path planning. As a Billing Processor, it can be promoted into senior positions as a Billing Analyst II that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Billing Processor. You can explore the career advancement for a Billing Processor below and select your interested title to get hiring information.
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