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This role has a flexible schedule after training, starting anywhere from 6-8am and working the full 8hrs, with 30min lunch break.

The ideal candidate will have

• Knowledge of CPT-4, ICD-9, and HCPCS codes, and CMS 1500 and/or UB04 forms,
• Good interpersonal skills, and strong decision making skills.
• Knowledge of Health Plan policies and/or AHCCCS regulations and IDX system.
• Ability to meet minimum production standards, research and process complex claims.

Your pay and benefits are important components of your journey at Banner Health. This opportunity includes the option to participate in a variety of health, financial, and security benefits.

POSITION SUMMARY
This position, under general direction, will provide support to the claims department leadership team, trainer/auditors and systems team to ensure the department’s compliance goals are met.

CORE FUNCTIONS
1. Data-enters and adjudicates internal and external claims on a timely basis in accordance with departmental policies, procedures and standards.

2. Researches resubmitted or corrected claims and pend appropriately. Adheres to governmental guidelines for processing claims.

3. Refers fee schedule, vendor contract, plan problems or concerns to manager or senior level processors for intervention. Enters Siebel requests for provider updates, medical review, enrollment review, and coding review. Trouble shoots, identifies, and resolves special handling requirements related to pricing, contracting, and system issues. Processes CMS 1500 and/or UB04 claims.

4. This position works under supervision, prioritizing data from multiple sources to provide quality care and support. Incumbents work in a fast-paced, sometimes stressful environment with a strong focus on customer service. Interacts with staff at all levels throughout the organization.

MINIMUM QUALIFICATIONS

Knowledge, skills and abilities typically obtained through two years of medical billing or claims processing experience or proven ability to be successful in this position.

Knowledge of CPT-4, ICD-9, and HCPCS codes, and CMS 1500 and/or UB04 forms. Good interpersonal skills, strong decision making skills.

Knowledge of Health Plan policies and/or AHCCCS regulations and IDX system. Ability to meet minimum production standards, research and process complex claims.

PREFERRED QUALIFICATIONS

Two years of IDX claims system experience preferred.

Additional related education and/or experience preferred.

EOE/Female/Minority/Disability/Veterans

Our organization supports a drug-free work environment.

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