Claims Examiner
Tucson, AZ · On-site
... Medicaid Claims, In-Patient Billing, and Rejections. Under general supervision from the Director of Operations, the responsibility of Claims Examiner consists of processing claim data and ...
Claims Examiner
Tucson, AZ · On-site
... Medicaid Claims, In-Patient Billing, and Rejections. Under general supervision from the Director of Operations, the responsibility of Claims Examiner consists of processing claim data and ...
Claims Processing Executive
Phoenix, AZ · On-site
$17 - $21.25/hr
Claims Processing Executive Duration: 6-12 months Location: Onsite. Work Type: Rate: Pay range ... Confirm patient coverage, benefits, and pre-authorization requirements under Medicare, Medicaid ...
Quick apply
Claims Processing Executive
Phoenix, AZ · On-site
$17 - $21.25/hr
Claims Processing Executive Duration: 6-12 months Location: Onsite. Work Type: Rate: Pay range ... Confirm patient coverage, benefits, and pre-authorization requirements under Medicare, Medicaid ...
Medical Claims Examiner
Tucson, AZ · On-site
... Medicaid Claims, In-Patient Billing, and Rejections. Under general supervision from the Director of Operations, the responsibility of Medical Claims Examiner consists of processing claim data and ...
Medical Claims Examiner
Tucson, AZ · On-site
... Medicaid Claims, In-Patient Billing, and Rejections. Under general supervision from the Director of Operations, the responsibility of Medical Claims Examiner consists of processing claim data and ...
Medical Claims Coder
Tucson, AZ · On-site
... Medicaid Claims, In-Patient Billing, and Rejections. Under general supervision from the Director of Operations, the responsibility of Medical Claims Coder consists of processing claim data and ...
Medical Claims Coder
Tucson, AZ · On-site
... Medicaid Claims, In-Patient Billing, and Rejections. Under general supervision from the Director of Operations, the responsibility of Medical Claims Coder consists of processing claim data and ...
Medicaid Facilitator
Phoenix, AZ · On-site
ASAP Job Summary The Medicaid Facilitator manages and coordinates all aspects of the Medicaid ... Key objectives include ensuring compliance with state and federal regulations, processing claims ...
Medicaid Facilitator
Phoenix, AZ · On-site
ASAP Job Summary The Medicaid Facilitator manages and coordinates all aspects of the Medicaid ... Key objectives include ensuring compliance with state and federal regulations, processing claims ...
Medicaid Facilitator
Phoenix, AZ · On-site
ASAP Job Summary The Medicaid Facilitator manages and coordinates all aspects of the Medicaid ... Key objectives include ensuring compliance with state and federal regulations, processing claims ...
Medicaid Facilitator
Phoenix, AZ · On-site
ASAP Job Summary The Medicaid Facilitator manages and coordinates all aspects of the Medicaid ... Key objectives include ensuring compliance with state and federal regulations, processing claims ...
Lead Java/AWS Architect
Phoenix, AZ · On-site
In this role, you will lead the design and delivery of secure, scalable and cloud-enabled enterprise applications that support Medicare and Medicaid claims processing, payer workflows and mission ...
Lead Java/AWS Architect
Phoenix, AZ · On-site
In this role, you will lead the design and delivery of secure, scalable and cloud-enabled enterprise applications that support Medicare and Medicaid claims processing, payer workflows and mission ...
... Biller, AHCCCS, Medicare, Medicaid, Medical Claims, Follow-Up Rep, Medical Collections ... Processing, Payment Poster, and Claims Processor. We never charge a fee to candidates, and all ...
Quick apply
... Biller, AHCCCS, Medicare, Medicaid, Medical Claims, Follow-Up Rep, Medical Collections ... Processing, Payment Poster, and Claims Processor. We never charge a fee to candidates, and all ...
Billing Processor
Tucson, AZ · On-site
$15.75 - $20.25/hr
A minimum of 1 year processing claims as assigned to the primary Medicaid ERA funder Certified Professional Coder * Active AAPC Certification Certifications: * Certified Coder, preferred Additional ...
Billing Processor
Tucson, AZ · On-site
$15.75 - $20.25/hr
A minimum of 1 year processing claims as assigned to the primary Medicaid ERA funder Certified Professional Coder * Active AAPC Certification Certifications: * Certified Coder, preferred Additional ...
Billing Processor
$15.75 - $20.25/hr
A minimum of 1 year processing claims as assigned to the primary Medicaid ERA funder Certified Professional Coder * Active AAPC Certification Certifications: * Certified Coder, preferred Additional ...
Billing Processor
$15.75 - $20.25/hr
A minimum of 1 year processing claims as assigned to the primary Medicaid ERA funder Certified Professional Coder * Active AAPC Certification Certifications: * Certified Coder, preferred Additional ...
Billing Processor I, II or CPC
Tucson, AZ · On-site
$17 - $22/hr
A minimum of 1 year processing claims as assigned to the primary Medicaid ERA funder * Certified Professional Coder * Active AAPC Certification Other: * Bilingual skills a plus. * Use of Microsoft ...
Billing Processor I, II or CPC
Tucson, AZ · On-site
$17 - $22/hr
A minimum of 1 year processing claims as assigned to the primary Medicaid ERA funder * Certified Professional Coder * Active AAPC Certification Other: * Bilingual skills a plus. * Use of Microsoft ...
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Medical Biller - Behavioral Health Revenue Cycle Representative
Phoenix, AZ · On-site
$19 - $21/hr
... Biller, AHCCCS, Medicare, Medicaid, Medical Claims, Follow-Up Rep, Medical Collections ... Processing, Payment Poster, and Claims Processor. We never charge a fee to candidates, and all ...
Quick apply
Be Seen First
Medical Biller - Behavioral Health Revenue Cycle Representative
Phoenix, AZ · On-site
$19 - $21/hr
... Biller, AHCCCS, Medicare, Medicaid, Medical Claims, Follow-Up Rep, Medical Collections ... Processing, Payment Poster, and Claims Processor. We never charge a fee to candidates, and all ...
Medical / Behavioral Insurance Verification
$17 - $21.50/hr
... Biller, AHCCCS, Medicare, Medicaid, Medical Claims, Follow-Up Rep, Medical Collections ... Processing, Payment Poster, and Claims Processor. We never charge a fee to candidates, and all ...
Quick apply
Medical / Behavioral Insurance Verification
$17 - $21.50/hr
... Biller, AHCCCS, Medicare, Medicaid, Medical Claims, Follow-Up Rep, Medical Collections ... Processing, Payment Poster, and Claims Processor. We never charge a fee to candidates, and all ...
Claims Examiner
Glendale, AZ · On-site
Dunlap Ave Phoenix AZ 85021 Duration - 3 months Contract Processing basic payments and/or claim denials for Medicaid medical claims; demonstrating the highest levels of customer service, technical ...
Claims Examiner
Glendale, AZ · On-site
Dunlap Ave Phoenix AZ 85021 Duration - 3 months Contract Processing basic payments and/or claim denials for Medicaid medical claims; demonstrating the highest levels of customer service, technical ...
Claims Examiner
Glendale, AZ · On-site
Dunlap Ave Phoenix AZ 85021 Duration - 3 months Contract Processing basic payments and/or claim denials for Medicaid medical claims; demonstrating the highest levels of customer service, technical ...
Claims Examiner
Glendale, AZ · On-site
Dunlap Ave Phoenix AZ 85021 Duration - 3 months Contract Processing basic payments and/or claim denials for Medicaid medical claims; demonstrating the highest levels of customer service, technical ...
Sr. Government Healthcare Data Consultant (HEDIS)
Phoenix, AZ · On-site
$115K - $230K/yr
... Medicaid claims data, including experience navigating common data quality and completeness challenges * Direct experience taking measures through NCQA's HEDIS Measure Certification process ...
Sr. Government Healthcare Data Consultant (HEDIS)
Phoenix, AZ · On-site
$115K - $230K/yr
... Medicaid claims data, including experience navigating common data quality and completeness challenges * Direct experience taking measures through NCQA's HEDIS Measure Certification process ...
Patient Access Representative
Glendale, AZ · On-site
$17.25 - $22/hr
... Biller, AHCCCS, Medicare, Medicaid, Medical Claims, Follow-Up Rep, Medical Collections ... Claims Processing. IND #2
Quick apply
Patient Access Representative
Glendale, AZ · On-site
$17.25 - $22/hr
... Biller, AHCCCS, Medicare, Medicaid, Medical Claims, Follow-Up Rep, Medical Collections ... Claims Processing. IND #2
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Patient Access Representative and Hospital Admitting
Glendale, AZ · On-site
$18 - $21/hr
... Biller, AHCCCS, Medicare, Medicaid, Medical Claims, Follow-Up Rep, Medical Collections ... Claims Processing. Company Description TTF is a recruiting firm that partners with companies ...
Quick apply
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Patient Access Representative and Hospital Admitting
Glendale, AZ · On-site
$18 - $21/hr
... Biller, AHCCCS, Medicare, Medicaid, Medical Claims, Follow-Up Rep, Medical Collections ... Claims Processing. Company Description TTF is a recruiting firm that partners with companies ...
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Medical Patient Access and Admitting Representative
Prescott, AZ · On-site
$18 - $21/hr
... Biller, AHCCCS, Medicare, Medicaid, Medical Claims, Follow-Up Rep, Medical Collections ... Claims Processing. Company Description TTF is a recruiting firm that partners with companies ...
Quick apply
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Medical Patient Access and Admitting Representative
Prescott, AZ · On-site
$18 - $21/hr
... Biller, AHCCCS, Medicare, Medicaid, Medical Claims, Follow-Up Rep, Medical Collections ... Claims Processing. Company Description TTF is a recruiting firm that partners with companies ...
Patient Registration Representative
Mesa, AZ · On-site
$17.75 - $24.50/hr
... Biller, AHCCCS, Medicare, Medicaid, Medical Claims, Follow-Up Rep, Medical Collections ... Claims Processing. IND #2
Quick apply
Patient Registration Representative
Mesa, AZ · On-site
$17.75 - $24.50/hr
... Biller, AHCCCS, Medicare, Medicaid, Medical Claims, Follow-Up Rep, Medical Collections ... Claims Processing. IND #2
Medicaid Claims Processing information
What is a Medicaid claims processing job?
A Medicaid Claims Processing job involves reviewing, verifying, and processing healthcare claims submitted by providers seeking reimbursement for services rendered to Medicaid beneficiaries. Workers in this role ensure claims comply with state and federal regulations, identify errors or discrepancies, and communicate with healthcare providers to resolve issues. They may also use specialized software to input and track claims, process denials or appeals, and ensure timely and accurate payments. Strong attention to detail, knowledge of Medicaid policies, and proficiency with healthcare billing codes are essential for success in this role.
What are the key skills and qualifications needed to thrive in Medicaid claims processing?
Success in Medicaid Claims Processing requires excellent attention to detail, a thorough understanding of healthcare billing procedures, and familiarity with Medicaid regulations and insurance guidelines. Proficiency in medical billing software, claims management systems, and sometimes industry certifications such as Certified Professional Coder (CPC) is beneficial. Strong organizational skills, problem-solving abilities, and effective written and verbal communication help individuals excel in this role. These skills and qualifications are crucial for ensuring accurate, timely claims processing and compliance with ever-evolving Medicaid requirements.
What are some typical challenges faced in Medicaid claims processing, and how can I prepare for them?
One of the main challenges in Medicaid Claims Processing is staying up-to-date with frequently changing policies, billing codes, and compliance requirements, which can vary by state and program. Professionals in this role must pay close attention to detail to avoid errors and denials, often working with tight deadlines and large volumes of claims. To prepare, it's helpful to become familiar with Medicaid guidelines, maintain strong organizational habits, and proactively seek out updates in regulations or coding standards. Collaborating with other team members, such as care coordinators and billing specialists, is essential to ensure claims are accurate and properly documented. Ongoing learning and adaptability are key for long-term success in this dynamic environment.
How to get a job as a Medicaid Claims Processing specialist?
To become a Medicaid Claims Processing specialist, candidates typically need a high school diploma or equivalent, with some roles requiring postsecondary education or certifications in healthcare administration or related fields. Relevant skills include knowledge of healthcare billing, claims processing software, and federal Medicaid policies; experience in healthcare or insurance is often preferred. Applying through healthcare organizations, government agencies, or insurance companies and demonstrating attention to detail and familiarity with claims systems can improve job prospects.
Is a Medicaid claims processing job in demand?
Medicaid claims processing jobs are in steady demand due to ongoing healthcare coverage needs and the complexity of processing claims. These roles often require knowledge of healthcare regulations and claims management software, making them essential in healthcare administration and insurance companies.
What are the most commonly searched types of Medicaid Claims Processing jobs in Arizona?
The most popular types of Medicaid Claims Processing jobs in Arizona are:
What are popular job titles related to Medicaid Claims Processing jobs in Arizona?
For Medicaid Claims Processing jobs in Arizona, the most frequently searched job titles are:
- Medicare Claims Processor
- Remote Subrogation Analyst
- Remote Computational Drug Discovery Salary
- Remote Unemployment Claims Adjudication
- Remote Medical Claims Processor
- Death Certificate
- Remote Claims Processing
- Insurance Claims Specialist
- Claims Representative Associate
- Home Based Construction Claims Consultant
What job categories do people searching Medicaid Claims Processing jobs in Arizona look for?
The top searched job categories for Medicaid Claims Processing jobs in Arizona are:
Full-time
Medical, Retirement, PTO
Re-posted 29 days ago
Job description
Claims Examiner, Tucson, AZ
The Claims Examiner needs experience with ICD-10, Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), In-Patient Billing, Rejections, Accounts Receivable (A/R), Account Reconciliation, and Prior Authorizations. Candidates also need experience with Medicare/Medicaid Billing, Medicare/Medicaid Claims, In-Patient Billing, and Rejections.
Under general supervision from the Director of Operations, the responsibility of Claims Examiner consists of processing claim data and adjudicating medical and inpatient claims received from all provider types and lines of business. Review and resolve rejected and/or denied claims. Conduct research and analysis of claims; facilitate resolution of specific claims issues. Monitor copays, deductibles, insurance verification, and authorizations. Analyze incoming and outgoing revenue sources and measure different financial cycles on behalf of customers. Maximize reimbursement and develop effective policies for billing and claim processing. This position is 100% Onsite and NOT open for Remote.
Claims Examiner Responsibilities:
- Submit claims and encounters in a timely manner.
- Review and resolve rejected, pended, and/or denied claims within expected timeframes.
- Coordinate claim adjustments with the customer.
- Identify revenue cycle issues and implement solutions to improve systems and processes.
- Respond to calls on claims issues and provide information and resolution in a timely manner.
- Provide education and technical support to Claims Examiners and customers regarding claims related issues through on-line training and in person training.
- Produce scheduled reports for in-house and customers.
- Prepare written inter-departmental and external correspondence.
- Develop and publish formal written guidance for customers to process claims.
- Analyze encounter-processing data using statistical methodologies.
- Update and maintain electronic billing manual and distribute updates as directed.
- Compare business operations and coordinate technical analysis support for upcoming collection of accounts.
Claims Examiner Qualifications:
- The Claims Examiner needs experience with ICD-10, Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), In-Patient Billing, Rejections, Accounts Receivable (A/R), Account Reconciliation, and Prior Authorizations.
- Candidates also need experience with Medicare/Medicaid Billing, Medicare/Medicaid Claims, In-Patient Billing, and Rejections.
- High School diploma or GED plus 5 years of full-time data entry experience in claims processing, accounting, analysis and adjudication of Medical and/or Behavioral environment.
- Experience with ICD-10, CPT, Healthcare Common Procedure Coding System (HCPCS), and Inpatient coding and billing and knowledge of HIPAA regulations.
- Knowledge of Microsoft Excel and 10-key by touch is also required.
- Knowledge of and experience working with Electronic Health Records system(s).
- Ability to translate customer needs to technical and/or business process solutions.
- Ability to effectively work with internal teams across numerous functions and levels.
- Ability to quickly learn complex business processes and understand the underlying transactional systems.
- Strong customer service skills and abilities.
- Exceptional communication skills, including strong customer-facing presentation and facilitation skills.
- Ability to work on multiple projects.
- Strong attention to detail and follow-through skills.
- Experience working in a team-oriented, collaborative environment.
- Strong analytical and problem-solving abilities.
Benefits include medical insurance, retirement plan, PTO, etc. Salary: 80K+ DOE. Keywords: Tucson AZ Jobs, Claims Examiner, ICD-10, CPT, Healthcare Common Procedure Coding System, HCPCS, In-Patient Coding, In-Patient Billing, HIPAA Regulations, MS Excel 10-Key, Electronic Health Records, EHR, Claims Processing, Accounting, Healthcare, Arizona Recruiters, Information Technology Jobs, IT Jobs, Arizona Recruiting
Looking to hire for similar positions in Tucson, AZ or in other cities? Our IT recruiting agencies and staffing companies can help.
We help companies that are looking to hire Claims Examiners for jobs in Tucson, Arizona and in other cities too. Please contact our IT recruiting agencies and IT staffing companies today! Phone 630-428-0600 ext. 11 or email us at jobs@nextstepsystems.com. Click here to submit your resume for this job and others.
Atlanta Georgia IT Recruiters, Austin TX IT Recruiters, Baltimore Executive Staffing, Boston IT Recruiters, Charlotte IT Recruiters, Chicago Recruiting Agency, Cincinnati Executive Search Firms, Cleveland Executive Tech Recruiting, Columbus Technical Recruiters, Dallas Recruiters for IT, Denver Technology Headhunters, Detroit IT Headhunters, Fort Lauderdale Information Technology Recruiters, Houston IT Recruiters, Indianapolis IT Recruiters, Jacksonville IT Recruiters, Kansas City IT Recruiters, Los Angeles IT Recruiters, Miami IT Recruiters, Minneapolis IT Recruiters, Nashville IT Recruiters, New Jersey Tech Recruiters, New York IT Recruiters, Phoenix IT Recruiters, Raleigh IT Recruiters, Salt Lake City IT Recruitment, San Antonio Information Technology Recruiters, San Diego Executive Staffing, San Francisco Executive Search Firms, San Jose Executive Tech Recruiting, Seattle Technical Recruiters, Silicon Valley Tech Recruiters, St. Louis Technology Headhunters, Tampa Technology Headhunters, Washington DC IT Recruiters
Home"Claims Examiner
The Claims Examiner needs experience with ICD-10, Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), In-Patient Billing, Rejections, Accounts Receivable (A/R), Account Reconciliation, and Prior Authorizations. Candidates also need experience with Medicare/Medicaid Billing, Medicare/Medicaid Claims, In-Patient Billing, and Rejections.
Under general supervision from the Director of Operations, the responsibility of Claims Examiner consists of processing claim data and adjudicating medical and inpatient claims received from all provider types and lines of business. Review and resolve rejected and/or denied claims. Conduct research and analysis of claims; facilitate resolution of specific claims issues. Monitor copays, deductibles, insurance verification, and authorizations. Analyze incoming and outgoing revenue sources and measure different financial cycles on behalf of customers. Maximize reimbursement and develop effective policies for billing and claim processing. This position is 100% Onsite and NOT open for Remote.
Claims Examiner Responsibilities:
- Submit claims and encounters in a timely manner.
- Review and resolve rejected, pended, and/or denied claims within expected timeframes.
- Coordinate claim adjustments with the customer.
- Identify revenue cycle issues and implement solutions to improve systems and processes.
- Respond to calls on claims issues and provide information and resolution in a timely manner.
- Provide education and technical support to Claims Examiners and customers regarding claims related issues through on-line training and in person training.
- Produce scheduled reports for in-house and customers.
- Prepare written inter-departmental and external correspondence.
- Develop and publish formal written guidance for customers to process claims.
- Analyze encounter-processing data using statistical methodologies.
- Update and maintain electronic billing manual and distribute updates as directed.
- Compare business operations and coordinate technical analysis support for upcoming collection of accounts.
Claims Examiner Qualifications:
- The Claims Examiner needs experience with ICD-10, Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), In-Patient Billing, Rejections, Accounts Receivable (A/R), Account Reconciliation, and Prior Authorizations.
- Candidates also need experience with Medicare/Medicaid Billing, Medicare/Medicaid Claims, In-Patient Billing, and Rejections.
- High School diploma or GED plus 5 years of full-time data entry experience in claims processing, accounting, analysis and adjudication of Medical and/or Behavioral environment.
- Experience with ICD-10, CPT, Healthcare Common Procedure Coding System (HCPCS), and Inpatient coding and billing and knowledge of HIPAA regulations.
- Knowledge of Microsoft Excel and 10-key by touch is also required.
- Knowledge of and experience working with Electronic Health Records system(s).
- Ability to translate customer needs to technical and/or business process solutions.
- Ability to effectively work with internal teams across numerous functions and levels.
- Ability to quickly learn complex business processes and understand the underlying transactional systems.
- Strong customer service skills and abilities.
- Exceptional communication skills, including strong customer-facing presentation and facilitation skills.
- Ability to work on multiple projects.
- Strong attention to detail and follow-through skills.
- Experience working in a team-oriented, collaborative environment.
- Strong analytical and problem-solving abilities.
Benefits include medical insurance, retirement plan, PTO, etc. Salary: 80K+ DOE. Keywords: Tucson AZ Jobs, Claims Examiner, ICD-10, CPT, Healthcare Common Procedure Coding System, HCPCS, In-Patient Coding, In-Patient Billing, HIPAA Regulations, MS Excel 10-Key, Electronic Health Records, EHR, Claims Processing, Accounting, Healthcare, Arizona Recruiters, Information Technology Jobs, IT Jobs, Arizona Recruiting
Looking to hire for similar positions in Tucson, AZ or in other cities? Our IT recruiting agencies and staffing companies can help.
We help companies that are looking to hire Claims Examiners for jobs in Tucson, Arizona and in other cities too. Please contact our IT recruiting agencies and IT staffing companies today! Phone 630-428-0600 ext. 11 or email us at jobs@nextstepsystems.com. Click here to submit your resume for this job and others.
Atlanta Georgia IT Recruiters, Austin TX IT Recruiters, Baltimore Executive Staffing, Boston IT Recruiters, Charlotte IT Recruiters, Chicago Recruiting Agency, Cincinnati Executive Search Firms, Cleveland Executive Tech Recruiting, Columbus Technical Recruiters, Dallas Recruiters for IT, Denver Technology Headhunters, Detroit IT Headhunters, Fort Lauderdale Information Technology Recruiters, Houston IT Recruiters, Indianapolis IT Recruiters, Jacksonville IT Recruiters, Kansas City IT Recruiters, Los Angeles IT Recruiters, Miami IT Recruiters, Minneapolis IT Recruiters, Nashville IT Recruiters, New Jersey Tech Recruiters, New York IT Recruiters, Phoenix IT Recruiters, Raleigh IT Recruiters, Salt Lake City IT Recruitment, San Antonio Information Technology Recruiters, San Diego Executive Staffing, San Francisco Executive Search Firms, San Jose Executive Tech Recruiting, Seattle Technical Recruiters, Silicon Valley Tech Recruiters, St. Louis Technology Headhunters, Tampa Technology Headhunters, Washington DC IT Recruiters
Home"Claims Examiner
About Next Step Systems
Sourced by ZipRecruiter
Industry
It services
Company size
11 - 50 Employees
Headquarters location
Naperville, IL, US
Year founded
1995