Address:  2500 E Van Buren St
Phoenix, AZ 85008

Salary: $75,000 

Grade: 23

This position is responsible for ensuring 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.

Manage the billing, collections, and posting process for all payments owed to ASH and ACPTC for services provided to patients and residents. Includes billing primary insurance (including Medicare, Medicaid, and/or AHCCCS), Arizona counties and other governmental units, family, guardians and patient/resident accounts, as allowed by relevant laws, regulations and policies.

Manage the processing of payments to external providers of medical services, prescriptions and durable goods. First ensuring that payments are made by valid and collectible insurance plans, before processing payments from ASH/ACPTC in accordance with existing agreements and standard medical payment processes.

Communicate with patients/residents, their family and guardians as to financial ability to pay. Ensure that all billing is made in compliance with court orders, other legal directives and standard medical billing practices.

Maintain an accurate record of primary insurance coverage for all ASH/ACPTC patients and residents. Re-verify and update as needed in compliance with industry standards. Communicate insurance coverage as needed to external providers, in compliance with HIPAA

Ensure that billed amounts, payments, and write offs are properly recorded in the ASH/ACPTC EHR and in the State of Arizona accounts receivable system.

Provide timely updates to supervisors of financial impact and projections for accounts receivable and payments to third party providers. Recommend policy changes to Arizona DHS Finance and ASH/ACPTC leadership, to include financial impacts of those recommendations. Create and maintain comprehensive documentation of all standard operating processes related to position.

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

Knowledge:
-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.

Skills:
-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:
-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. Four 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 pilot 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 email to virginia.hassard@adhs.gov. 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.