About This Opportunity
Department: Claims Processing
Support the Claims Department by processing claims for payment at the production, quality and timeliness levels determined appropriate. Job duties include:
· Processes all assigned claims within the Analyst I category in addition to a minimum of 3 claim types in the Analyst II category in accordance with department standards for accuracy, productivity, and timeliness.
· Checks procedure codes and diagnosis codes for correct billing procedures.
· Denies all claims not submitted in the correct format or without required documentation.
· Pends claims in accordance with Plan procedures. Processes pended claims after appropriate review.
· Performs research on claim issues resulting from telephone calls and correspondence submitted by providers and other parties, including timely follow-up with originator of the research as needed.
· Identifies and reviews unusual claims with Team Leader.
Special Skills: Proficient in ICD-9, CPT, and HCPCs coding. Strong data entry, 10-key and general numerical analytical skills required. Must be highly organized and able to work successfully in a team environment.
Minimum Requirements: High School/GED required. Minimum of one to three years of prior work experience preferably in healthcare as a claims analyst in a high volume computerized environment.
Preferred Qualifications: Previous claims experience in an AHCCCS environment is preferred.
Schedule: Full Time
Shift: Day Shift
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About Abrazo Health Care
Abrazo Health Care’s five acute care hospitals consist of Arrowhead Hospital, Maryvale Hospital, Paradise Valley Hospital, Phoenix Baptist Hospital and West Valley Hospital. Each hospital offers a broad range of medical services including internal medicine, general surgery, cardiology, orthopedics, obstetrics, women’s health, diagnostic imaging and emergency care. Outpatient services include outpatient surgery, laboratory, radiology and rehabilitation services. Additionally Abrazo includes Arizona Heart Hospital, a campus of Phoenix Baptist Hospital, known for its distinct reputation as a premier cardiovascular specialty hospital and center of excellence dedicated exclusively to cardiac and cardiovascular care.
For more information and opportunities, see Abrazo Health Care.