QA Billing Specialist

Description

Purpose of Position:

Assists Quality Assurance Manager with membership processing, maintaining files, provides timely financial reports and other reports as needed.  Responsible for sometimes covering phone calls for STAR business lines in a professional manner, and acts as support staff.

Requirements

Essential Functions:

• Ensures daily member logs (signing in and out) are accurate and input into the computer, making sure all days are accounted for
• Ensures daily transportation logs are accurate and input into the computer, making sure all days are accounted for
• Ensures all billing is processed in a timely manner
• Maintains member’s files, membership database, and operation department files
• Supplies support services to staff as needed
• Prepares monthly activity reports and monthly billing reports
• Works with Microsoft Office software to produce statistical reports as needed for the Executive Leadership team.
• Assists Quality Assurance Manager as needed with clerical support
• Processes membership application
• Keeps membership applications in an orderly fashion and turn in completed applications to Quality Assurance Manager
• Communicates with AHCCCS, Mercy Maricopa Integrated Care and Case Managers to verify information.
• Weekly Timelines and Status Reports
• Other duties as assigned:
• Prepares new members report for management meeting
• Outreach to clinics for missing documents monthly
• Re-enroll members who’s MMIC eligibility has ended
• Credible training
• Internal spreadsheet audits.
• Scanning source documents
• Outreach to clinics to obtain member documents.
• Fax STAR monthlies to clinics.
• Prepare list of missing STAR Documents

Company Driver?Yes No

Safety Sensitive?Yes No

Transports Clients?YesNo

Physical Requirements:

        Occasionally            Rarely

Sitting

Standing

Walking

Climbing/Balancing

Reaching – with Arms & Hands

Stooping/Kneeling/Crouching/Crawling                                       

Talking

Hearing

Feeling/Touching

Vision (Close, Peripheral, Depth, Ability to Adjust Focus) x

Lifting up to 10 lbs

Lifting 10-25 lbs

Lifting 25-50 lbs

Lifting more than 50 lbs

Education

GED or High School Diploma  Required

Experience:

1 yr billing experience  Preferred

Knowledge, Skills & Abilities:

         Good organization and communication skills

         Computer literate

         Friendly and outgoing and able to empathize with consumers

         Must know Microsoft Office

Professional Certifications & Licenses:

None  Required  

Other requirements:

Self-identify as a Peer by the International Association of Peer Supporters (INAPS)

or Mental Health America definition and/or have (or have had a history) of a

Mental Health/Behavioral Health or Substance Use/Abuse Diagnosis                                                                     

(Bona Fide Occupational Qualification)         Preferred

At least 21 years of age (Bona Fide Occupational Qualification)              Preferred

Valid AZ Driver’s License  - Preferred

Criminal Background Verification  Required       

Pre-Hire and Random Drug/Alcohol Screening  Required

Personal Vehicle   Preferred