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Located in Phoenix, AZ
Overview We are seeking a detail-oriented and driven Behavioral Health Claims Specialist / Medical Biller to join our team. This role supports the day-to-day operations of the claims department by gathering information, processing high-volume behavioral health and psychiatric healthcare claims, and ensuring accurate and timely reimbursement. The ideal candidate is highly skilled in Medicaid AHCCCS Plans, thrives in a fast-paced environment, and is passionate about maximizing collections while maintaining compliance and accuracy.
Verify insurance eligibility for behavioral health services.
Scrub, batch, and file claims for accuracy, completeness, and compliance.
Reconcile electronic 837 transactions, payment files, and ensure claims are worked through to completion.
Troubleshoot denied or delayed claims with payers; analyze, research, and resubmit as needed.
Post payments and reconcile accounts to ensure accuracy.
Regularly correspond with insurance companies regarding outstanding or denied claims.
Maintain strict confidentiality of all claims and participant information.
Collaborate with internal teams to ensure proper documentation, coding, and billing practices.
Work toward and consistently achieve monthly collection goals.
High School Diploma or equivalent required; Associate’s degree in Medical Billing & Coding, CPC certification, or equivalent experience strongly preferred.
Minimum of 1–2 years’ experience in a healthcare claims or billing setting, with behavioral health experience preferred.
Proven experience with Medicaid AHCCCS Plans and high-volume claims processing.
Proficiency in Microsoft Excel (assessment required).
Experience with EHR and computerized billing functions; Credible Billing Software experience a plus.
Familiarity with electronic billing systems (837 transactions) and payment reconciliation.
Valid Driver’s License and acceptable three-year Motor Vehicle Record.
Valid Fingerprint Clearance Card or ability to obtain within 90 days of hire.
Not ideal for candidates with primarily manual entry billing backgrounds.
Strong problem-solving skills and persistence in pursuing payment.
Highly organized with excellent attention to detail.
Effective communicator with both internal staff and insurance representatives.
Ability to work independently while thriving in a high-volume, fast-paced environment.
Passion for getting payments collected and driving results.
Our Perks:
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