Overview
Billing/Eligibility Analyst I (Admin) Jobs in Phoenix, AZ at Native American Connections
MISSION:
Improving the lives of individuals and families through Native American culturally appropriate behavioral health, affordable housing, and community development services
POSITION SUMMARY:
Under the direct supervision of the Revenue Cycle Accountant should understand NAC policies and all funding sources and contracts. The position is responsible for ensuring each client is assessed for appropriate funding sources and updated regularly. Ensure all documentation is received and is accurately documented.
RESPONSIBILITIES:
Reviews all enrollments for eligibility; processes enrollments and verifies status of client coverage in Arizona Health Care Cost Containment System (AHCCCS), Medicare, Behavioral Health Coverage, private insurance or other funding
Submits and uploads the weekly 270-271 files from AHCCCS.
Submit for non-title enrollments for SABG
Review new chart creations for accuracy and completeness.
Analyze and review client claims prior to submission, sending corrections back writers or supervisors, if need to.
Ensure residential and medical services have authorizations in place
Review all prior authorization received and attach to services for billing
Coordinate with clinical staff with any extended stays and CCR are submitted in a timely manner.
Submit completed claims to clearing houses 837p
Uploading returning 277 files, submit for corrections immediately.
Uploading 835 files
Analyze and monitor denied claims; make appropriate adjustments for resubmissions or prepare for write off.
Create invoice and send to Tribal payor source, post payment when received in EHR.
Reconciling invoices with balance sheet reports and resolving any discrepancies
Ensure efficient claim processing utilizing software and hardware necessary to complete accurate data entry.
Attend meetings as required.
Other duties as assigned.
QUALIFICATIONS AND REQUIREMENTS:
High School or GED required. AA degree in related field preferred.
Knowledge of eligibility/billing/benefits/enrollment in a behavioral health setting and a minimum of 2 years related work experience
Experience with Arizona Medicaid MCOs, RHBAs and TRBHAs eligibility
Experience in AHCCCS enrollment and benefit verification processes
Knowledge of HIMS/AXIOM preferred, or other EHR software
Detail oriented, able to multi-task, and meet deadlines
Experience in working with the Native American population preferred
Proficiency MS Office, especially Excel.
Able to effectively interact with others in a positive and professional environment.
Demonstrate critical thinking, problem-solving and time management skills.
Strong communication skills.
FAIR LABOR STANDARDS ACT:
This position is Non-Exempt as provided by the Federal Fair Labor Standards Act (FLSA) and any applicable state laws. Non-Exempt employees are entitled to overtime pay for hours worked in excess of forty (40) hours per workweek.
DRUG FREE WORKPLACE: Native American Connections is a drug-free workplace with safety-sensitive jobs. Use of alcohol and legal or illegal drugs may impair and alter employees’ judgement resulting in increased safety risks, workplace injuries, and faulty decision making. Reporting to work at NAC after use of alcohol, a controlled substance, or abuse of any other substance is absolutely prohibited.
INDIAN PREFERENCE:Preference may be given to qualified Native American Indians according to the Indian Preference Hiring Act, CFR 25 USC 472. Other than Indian Preference, Native American Connections, Inc. adheres to all provisions of the Equal Employment Opportunities Act.
Title: Billing/Eligibility Analyst I (Admin)
Company: Native American Connections
Location: Phoenix, AZ
Category:
