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Claims Specialist

Eloy, AZ 85131

Posted: 03/15/2023 Industry: Accounting Job Number: 69011

Job Description

Staff Matters, LLC a subsidiary of NSC Technologies has an immediate opening Claims Specialist

Job Title:  Claims Specialist

Pay rate: $18 - 19.50 per hour

Hours:  M-F – 8-5 p.m. 

Job responsiblities:



Claims submission to Commercial plans, AHCCCS and Regional Behavioral Health Authority (RBHA), both contracted and non-contracted, for final resolution. o Ensures accurate and timely filing.
Reprocessing of denied claims with follow up to paid resolution/adjustment. o Recognizing and reporting trends
Validates NPI/Tax ID
Validates payor ID
Works with EVOLV systems and Internal Departments.
COB/TLP claims processing.
Appeals and Grievances.
Self-pay plan review/billing.
Payment posting.
Produces reports for internal and external customers and assists in the preparation of presentations for upper management and providers.
Communicates with Insurance representatives for updates and changes Via phone/WebEx/trainings.
Responds to questions/situations regarding claims issues and provides information and resolution to the provider’s satisfaction.
Attends meetings related to the claims system.
Completes EVOLV trainings.
Maintains current knowledge of Billing Rules and Guidelines.
Knowledge of CPT, ICD-10, HCPC codes/coding.
Maintains an approved schedule and acceptable level of attendance.
Performs other duties as assigned or necessary it relates to the general nature of the position.

QUALIFICATIONS:
  • Education – High School diploma or GED required.
  • Experience – 5 years of claims processing experience preferred. Behavioral health billing experience preferred.
  • Certification- Certified Professional Coder or AAPC/AMA Certification preferred.

Regulatory –
  • o Minimum 21 years of age.
  • o Arizona Driver’s License, 39-month Motor Vehicle Report and proof of vehicle registration and liability insurance that meets insurance requirements.
  • o Must possess Level 1 fingerprint clearance.

FOR IMMEDIATE CONSIDERATION CONTACT, Darrell Griffiths, Recruiter
darrellg@staffmattersinc.com  520.277.0844
STAFFMATTERS Cares!
At STAFFMATTERS our company culture is strong! You work hard for us and in return we want to provide you with as many benefits and resources as we can:
  • Medical Coverage
  • Dental
  • Vision
  • 401(k)
  • Short- and long-term disability coverage
  • Identity Theft Protection
  • Legal Assistance
  • Long Term Opportunities
  • Training and Career Growth Opportunities
  • The chance to be a part of an amazing team
STAFFMATTERS is committed to connecting good people with good jobs!
STAFFMATTERS is an innovative staffing firm that specializes in placing qualified administrative, light industrial, skilled, technical and professional talent in virtually any market. Our meticulous dedication to Quality and Safety is a testament to our success. We are The Staffing Experts!
STAFFMATTERS is a drug free company. STAFFMATTERS is an EOE AA/M/F/VHo/D.

 

Meet Your Recruiter

Darrell Griffiths

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