Job Description


Performs a variety of complex clerical and accounting functions for billing, including verification of invoice information, maintenance of third party billing records, and resolution of a variety of problems.  Follows up on submitted claims and billing; resubmits claims or resolves problems.

Essential Duties and Responsibilities

  1. Processes outbound 837 electronic bill submissions to payors.
  2. Verifies member Medicare, Commercial and AHCCCS benefits verification and services allowed.
  3. Works with payors to resolve Prior Authorizations discrepancies.
  4. Resolves denied and pended billing errors.
  5. Prepares and reports payor payment trends regarding denials, allowances, net cash receipts.
  6. Ensures billing systems are setup for optimal billing functions.
  7. Maintains billing, explanation of benefits, and Receipts filing system and records retention.
  8. Assists in resolving data validation audit findings.
  9. Resolves and assists billing team members with denied and pended billing errors.
  10. Posts receipts and Explanation of Benefits (EOB) via ERA and manual posting.
  11. Routinely monitors and ensures eligibility segments are documented correctly in NextGen.
  12. Performs other related duties in accordance with agency growth and changes.

Essential Duties and Responsibilities if Certified Professional Coder

  1. Answer calls and emails related to coding.
  2. Review denial notes to determine correctness in diagnosis, modifier & CPT code
  3. Assist providers in selecting correct CPT codes
  4. Assist Data Validation Audits

Skills / Requirements

Education:  Associates degree in related field preferred; additional experience may substitute for a degree.

Experience: 2-4 years billing & claims processing experience

Certifications: Certified Coder preferred

Additional Requirements:

  • Valid Arizona Driver’s license, proof of current insurance and willingness to use personal vehicle. 
  • Clean Motor Vehicle Record - no more than 2 moving violations or a license suspension in past 3 years.


  • Bilingual a plus.
  • Ability to interact effectively with other service providers.
  • Intermediate to advanced computer skills using MS Office products, Word, Excel, Access, etc., importing/exporting data to/from applications.
  • Ability to communicate effectively both orally and in writing

"Equal Opportunity Employer Minorities/Women/Veterans/Disabled"

Application Instructions

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