Claims Specialist (Medical)

Description

Easterseals Blake Foundation started as the Cerebral Palsy Foundation of Southern Arizona. Since then, we have expanded our services to better serve our community members. We are now one of Arizona's top providers of comprehensive behavioral health services, child welfare, and services for individuals with intellectual and developmental disabilities. We serve more than 40,000 individuals and families across 10 counties and support more than 3,700 children in Foster Care throughout Southern Arizona. Are you ready to make profound, positive differences in people's lives every day?

We offer our full-time employees the following benefits:

• Medical, Dental and Vision
• Flexible Spending Account and Dependent Flexible Spending Account
• Health Savings Account
• Voluntary Life insurance
• Voluntary Short-term Disability insurance
• Critical Illness insurance
• Accident insurance
• Employer paid life insurance, long-term disability insurance, and Employee Assistance Program

General Position Description: Work with insurance carriers to ensure timely reimbursement of billed charges and claims. 

Essential Duties and Responsibilities:

• Performs accounts receivable reconciliations from the customer level to the general Ledger. Reviews revenue postings for accuracy as needed.
• Reviews and prepares adjustment entries, which include but are not limited to debit memos, credit memos, and journal entries. Reviews accounts receivables aging report on a weekly basis.
• Reviews and maintains all receivable payors in EHR System. 
• Writes appeals and corresponds with assigned payors on reimbursement issues discovered.
• Works closely with Medical Billing to ensure funds are received timely. Monitors resubmission of denied and/or rejected billings, including medical claims.
• Prepares a weekly A/R status report of assigned payors for management. Researches revenue transactions from financial statements for Management. Reviews files and financial data in preparation for the annual audit.
• Assists with collections duties as needed. 
• Recommends Accounts Receivable process improvements. 
• Participates in the process of ongoing professional development and meetings. Maintains comprehensive communication among all contacts within the agency, members, and external agencies. Models professional standards and ethics in accordance with EBF Code of Conduct, Strategic Plan, Mission, and Vision. 
• Performs other duties as assigned.

Requirements

• Associate’s degree in Accounting or Business Administration or HS/GED with 3 years of accounts receivable experience required. Bilingual (Spanish) preferred. 
• Regulatory 
• Must be at least 18 years of age.
• Current, unrestricted AZ driver’s license with no more than two (2) minor moving violations or one (1) accident within the past three (3 years). Three (3) years of driving experience required.
• Must be able to pass a criminal background check.
• Ability to obtain and maintain an AZ DPS Level 1 fingerprint clearance card (employer provides).

Skills/Job Knowledge/Abilities: Able to establish and maintain a team atmosphere of communication and collaboration for all that reach out to the Department. Maintain up to date guidelines per industry/payor demands. Must be self-directed and be sensitive to cultural and linguistic diversity. Excellent customer service in stressful situations. Maintains a professional in appearance, communications, and actions. Excellent interpersonal communication skills. Excellent written communication. Possess a high level of computer proficiency. 

Working Conditions/Physical Requirements (with or without accommodation): Normal office environment with multiple interruptions in person and through computer and phone. Interacts with employees and members of the public on a daily basis. May lift normal office equipment and materials up to 25lbs. Visual acuity to read information from computer screens and forms. Able to speak clearly in conversations and general communications. Hearing ability for communication in persona, phone, and/or other electronic methods. Manual dexterity for typing and writing. Able to stoop, squat, reach, pull, push, stretch, ascend and descend stairs, stand and sit for long periods of time. May be required to work additional hours or days depending on circumstances. 

Easterseals Blake Foundation and Aviva are an Equal Employment Opportunity and Affirmative action employer that promotes a work environment of inclusion and diversity. We are committed to provide employment opportunities to all candidates based on their qualifications free of discrimination based on race, color, religion, national origin, sex (including pregnancy, sexual orientation or gender identity), age, disability, veteran status, genetic information, mental or physical disability, or any other characteristic protected by law.

If you have any questions, require assistance or reasonable accommodations while seeking employment, please contact the Human Resource Department at HR@blake.easterseals.com or call 520-327-1529.

Salary : $17 - $22