DEPT OF HEALTH SERVICES

Address: 501 N 24th St, Phoenix, AZ 85008

Salary: $55,000 

Grade: 16

Closing Date: 

This position is responsible for assisting with efforts to ensure that ASH and ACPTC are appropriately maximizing reimbursement for services provided to patients and residents, while at the same time correctly minimizing payments to external medical providers for required services for patients and residents. It requires close attention to detail, the ability to analyze and diligently follow through to completion complicated medical billing situations, and clear communication with medical service providers, insurance companies, patients/residents, and their family/guardians.

-Searches for and retrieves information from case files, and responds to informational requests requiring some judgment or discretion regarding current and specific business of the work system, as reflected in the records.

-Gathers and compiles information and data regarding assigned cases for use during discussions and negotiations with clients, attorneys, insurance companies, health plans and medical representatives.

-Composes correspondence dealing with subject matter in ways that call for considerable discretion and involve some judgment or negotiation, replying to inquiries, presenting or requesting information.

-Receives recovered funds and deposits with agency's accounting system for deposit in holding account; monitors disbursement of funds as approved.

-Prepares and files liens against all involved parties on behalf of agency pending resolvement of settlement for recovery of medical expenditures; amends and releases liens as approved.

-Researches case files and eligibility status of member; gathers information and data and contacts (phone or letter) representatives of state and county agencies, health care plans and liability insurance companies and attorneys to discuss and negotiate settlements in recovery of funds.

-Compares data from several sources to assure accuracy of report statements, descriptions or phraseology, according to established criteria, and relying upon some knowledge of the subject material.

-Other duties as assigned as related to the position (typically 5% - 10%)

Knowledge of:

- Understanding of medical billing, coding systems and claim forms.
- Knowledge of Medicare, Medicaid, HMOs, PPOs, and private insurance policies.
- Understanding of the full revenue cycle management process, from patient registration to final payment.
- Awareness of HIPAA regulations and billing compliance standards.
- Familiarity with EHR and practice management systems (e.g., myAvatar, Epic, Cerner, NextGen).
- Understanding of how to manage and follow up on unpaid claims and balances.

Skill in:

- Attention to detail, particularly related to accuracy in coding, billing, and entering patient data.
- Ability to identify and resolve claim denials, rejections, and billing discrepancies.
- Clear verbal and written communication with patients, insurance companies, and healthcare providers.
- Ability to explain billing issues to patients and handle inquiries professionally.
- Efficiently prioritize and manage multiple billing tasks and deadlines.

Ability to:

- Work both independently and as part of a team, by autonomously managing individual workload, while coordinating with medical and administrative staff.
- Resolve complex insurance and billing issues creatively and effectively.
- Handle sensitive patient and financial data in compliance with privacy laws.
- Adjust to policy changes, insurance updates, or software system transitions.
- Multitask, and handle multiple claims, follow-ups, and calls without loss of efficiency.

Associate degree or certificate or equivalent in Medical Billing and Coding, Health Information Technology, Healthcare Administration, Business Administration (with healthcare focus), or other related field. Experience with myAvatar EHR. Experience operating within state or local government, or a state university.

High school diploma or GED. Two years of relevant experience with either a medical services or insurance provider, and/or managing medical insurance claims for a population of 200 or more individuals.

If this position requires driving or the use of a vehicle as an essential function of the job to conduct State business, then the following requirements apply: Driver’s License Requirements.

All newly hired State employees are subject to and must successfully complete the Electronic Employment Eligibility Verification Program (E-Verify).

The State of Arizona provides an excellent comprehensive benefits package including:
− Affordable medical and dental insurance plans
− Paid vacation and sick time
− Paid Parental Leave-Up to 12 weeks per year paid leave for newborn or newly-placed foster/adopted child (pilot program).
− 10 paid holidays per year
− Wellness program and plans
− Life insurance
− Short/long-term disability insurance
− Defined retirement plan
− Award winning Infant at Work program
− Credit union membership
− Transit subsidy
− ADHS Student Assistance Pilot Program

Learn more about the Paid Parental Leave program here. For a complete list of benefits provided by The State of Arizona, please visit our benefits page

To help you build a financially secure future, the State makes monthly contributions to finance your retirement benefit. The State will make a contribution to the ASRS in an amount equal to your contribution. In other words, you and the State will each pay 50% of the total cost of the benefit. New State employees have a 27 week wait period for contributions to begin.

The State of Arizona is an Equal Opportunity/Reasonable Accommodation Employer. Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by calling (602) 542-1085. Requests should be made as early as possible to allow sufficient time to arrange the accommodation. DHS is an Equal Employment Opportunity Employer. All newly hired employees will be subject to E-Verify Employment Eligibility Verification.