Address: 800 West Washington Street, Phoenix, AZ 85007
Salary: $26.44 per hour
Grade: 18
Closing Date: June 23, 2025
Provides administrative support in the Medical Resources Office (MRO). Manages the administrative peer review process and ensures that each element is completed according to the applicable rules and statutes. Provides support for the Physician's and Pharmaceutical Fee Schedule by analyzing data, preparing reports and documenting progress. Participate in agency programs to improve overall function. Document activities as appropriate. Review and analyze documents that demonstrate potential billing conflicts and provide appropriate responses for the Informal Payment Dispute Resolution Program.
This position may offer the ability to work a hybrid remote schedule, reporting to office based upon the department's business needs and continual meeting of expected performance measures.
The State of Arizona strives for a work culture that affords employees flexibility, autonomy, and trust. Across our many agencies, boards, and commissions, many State employees participate in the State’s Remote Work Program and are able to work remotely in their homes, in offices, and in hoteling spaces. All work, including remote work, should be performed within Arizona unless an exception is properly authorized in advance.
Provide excellent customer support by appropriately managing calls, faxes, email, mail and other sources. Analyze the issue and provide information, presentations and resources as needed. Prepare and send official communication to stakeholders as directed regarding the elements of the MRO is required. Document the interactions.
Manage the administrative peer review process. Review requests either by email or Salesforce and determine the next steps. Communicate with the involved parties and verify the submitted information. Send requests to a contractor who provides the peer review services. Distribute the results of the review to the involved parties. Document the process.
Provide support to the Program Manager on the annual fee schedule updates. Analyze data and provide reports that outline healthcare utilization by injured workers. Compile documentation that supports proposed changes to the fee schedules. Participates in meetings to discuss fee schedule issues.
Provide administration support for the division by ordering supplies, processing invoices, and ensuring resources are appropriately utilized. Review and analyze documents that demonstrate potential billing conflicts and provide appropriate responses for the Informal Payment Dispute Resolution Program.
Participates in division and agency meetings and activities. Represent the division as occasion arises in agency committees. Participate in quality improvement exercises.
| Knowledge, Skills & Abilities (KSAs): |
KNOWLEDGE:
Utilization review procedures and Current Procedural Terminology (CPT) coding.
Medical Terminology.
Medical document preparation. Medical information maintenance and privacy laws.
Workers' Compensation laws and rules. ICD-10 use and meaning.
Basic data analysis.
SKILLS:
Use of Microsoft and Google Workspace. Use of basic office equipment.
Strong written, verbal and presentation skills.
Analyze complex issues and provide correct responses.
Manage complex issues.
ABILITIES:
Analyze concerns and provide appropriate guidance.
Interpret laws and rules.
Communicate with healthcare providers, attorneys, payers, and injured workers.
Manage workload with minimal direction.
Attention to detail.
Research information and provide summaries.
GED or High School Diploma and 3-5 years related experience.
| Pre-Employment Requirements: |
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 Arizona Department of Administration offers a comprehensive benefits package to include:
Sick leave
Vacation with 10 paid holidays per year
Paid Parental Leave-Up to 12 weeks per year paid leave for newborn or newly-placed foster/adopted child (pilot program).
Health and dental insurance
Retirement plan
Life insurance and long-term disability insurance
Optional employee benefits include short-term disability insurance, deferred compensation plans, and supplemental life insurance
By providing the option of a full-time or part-time remote work schedule, employees enjoy improved work/life balance, report higher job satisfaction, and are more productive. Remote work is a management option and not an employee entitlement or right. An agency may terminate a remote work agreement at its discretion.
Learn more about the Paid Parental Leave pilot program here. For a complete list of benefits provided by The State of Arizona, please visit our benefits page
You will be eligible to participate in the state employee health/disability insurance plan, and you are required to participate in the Arizona State Retirement System (ASRS). ASRS participation may begin immediately or upon your 27th week of employment. Contributions are matched by the employer.
If you have any questions, please feel free to call 602-542-5559 or email HR@azica.gov for assistance. The State of Arizona is an Equal Opportunity/Reasonable Accommodation Employer.