Enrollment & Billing Supervisor jobs in Arizona

Description

• Supervises daily operations of the billing team
• Ensures effective benefit verification and Prior Authorization processes
• Assists billing team members in resolving Prior Authorizations discrepancies and member eligibility verification
• Resolves and assists billing team members with pended billing errors for Medicare, Commercial and Medicaid payer claims
• Evaluates EOB denials, assists the team in resolution of denied claims and resubmit process.
• Prepares and reports payor payments, trends regarding denials, and trends regarding rejections.
• Routinely monitors and ensures eligibility segments are documented correctly.
• Routinely prepares, maintains and reports status of Payment Reconciliation Report and Unapplied Report
• Works directly with Data Validation team to review and resolve audit findings.
• Assists in review and updating of various billing processes and procedures.
• Meets regularly with direct reports to review goals and objectives, and to provide support to ensure accurate and timely billings.
• Continually assesses daily billing process, assists in implements changes and monitors results.
• Maintains and updates appropriate training documentation in accordance with agency and Billing department requirements.
• Resolves grievances and other personnel problems within position responsibilities. Provides input based on observations related to counseling and disciplinary issues. Implements corrective actions/performance improvement plans as required.
• Assist in developing policies and programs within the department.
• Acts as a positive role model for staff.
• Coordinates the assignment of tasks and helps resolve technical and operational problems. Evaluates the impact of solutions to ensure goals are achieved.
• Creates an environment that nurtures empowerment of staff members; encourages the development of self-directed work teams; proactively pursue and encourage continuous quality management and innovation.
• Provides effective coaching and administrative supervision of assigned staff.
• Ensures adequate equipment and supplies for assigned area.
• Ensures compliance to all health and safety regulations and requirements.
• Performs other duties as assigned in keeping with the growth and general responsibilities of the position.

Qualifications

• Associates degree in related field. Additional experience may substitute for a degree.

• 4-6 years billing & claims processing experience and
• A minimum of 2 years supervising others

• Certified Professional Coder, preferred

• Valid Arizona Drivers license, proof of current insurance and willingness to use personal vehicle. Drivers license is an essential requirement for performing duties for this position.
• Clean Motor Vehicle Record - no more than 2 moving violations or a license suspension in past 3 years.

• Bilingual skills a plus.
• Proficient verbal and written communications
• Proficient knowledge of healthcare claims best practices standards
• Understanding of AHCCCS, the Arizona healthcare delivery systems
• Working knowledge of Medicare claims processing
• Intermediate level of overall computer proficiency