Job description

Looking to build a lasting career? Join a team that is inclusive and embraces all individuals. Intermountain Centers is one of the largest statewide behavioral health and integrated care organizations in Arizona. What does building a lasting career look like?

• Top-level compensation packages
• Exceptional health, dental, and disability benefits
• Career and compensation advancement programs
• Student loan forgiveness programs
• 401k company match
• Bilingual pay differential
• Holiday, PTO and employer paid life insurance
• Clinical licensure supervision and reimbursement
• Evidence-based treatment approaches, training, and supervision
• One of the first fully vaccinated COVID-19 workplaces in Arizona

Intermountain Centers and its statewide affiliates, Community Partners Integrated Healthcare, Pinal Hispanic Council, Intermountain Health Center, Intermountain Foster Care, Behavioral Consultation Services and MHRI Housing are currently recruiting career-minded individuals interested in opportunities within the largest adult and child service continuum in Arizona.

Intermountain Centers is committed to the safety and well-being of our employees, our members, and the communities we serve and, as such, we require all employees to be fully vaccinated from the COVID-19 virus. Proof of full vaccination status is required prior to the start of employment.

General Summary: Under direction of the Claims Manager, the Claims Specialist is responsible for performing all levels of claims processing and review.

JOB RESPONSIBILITIES:

• Claims submission to Commercial plans, AHCCCS and Regional Behavioral Health Authority (RBHA), both contracted and non-contracted, for final resolution.
• Ensures accurate and timely filing.
• Reprocessing of denied claims with follow up to paid resolution/adjustment.
• 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:

• Minimum 21 years of age
• DPS Level I fingerprint clearance (must possess upon hire and maintain throughout employment)
• CPR, First Aid, AED certification, if required (must possess upon hire and maintain throughout employment).
• Current, valid Arizona Driver’s License and 39-month Motor Vehicle Report and proof of vehicle registration liability insurance to meet insurance requirements, if required.
• Initial current negative TB test result, if required (Employer provides).

Questions about this position? Contact us at HR@ichd.net.

ICHD is an equal opportunity employer. ICHD does not discriminate based on age, ethnicity, race, sex, gender, religion, national origin, creed, tribal affiliation, ancestry, gender identity, sexual orientation, marital status, genetic information, veteran status, socio-economic status, claims experience, medical history, physical or intellectual disability, ability to pay, source of payment, mental illness, and/or cultural and linguistic needs, as well as any other class protected by law.

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