Medical Claims Review Manager jobs in Mesa, AZ

Community Bridges, Inc. (CBI) is an integrated behavioral healthcare agency offering a variety of different programs throughout Arizona. CBI provides residential, outpatient, inpatient, patient-centered medical homes, medication-assisted treatment, and crisis services to individuals experiencing crisis, opioid use disorder, homelessness, and mental illness.

The Medical Billing Analyst will be responsible for the qualification, data analysis, data accuracy, preparing and submitting claims to payers. This position is responsible for timely and compliant claim submissions in accordance to the billing requirements set forth by the payers. This position is also responsible for monitoring and analyzing the quality of data reported in billing records to ensure that they are submitted in accordance to standards, policies and procedures and will initiate necessary corrections to ensure the quality of the information billed.

The ideal candidate will be a self-starter with strong attention to detail and an ability to work in a fast-paced environment.

Duties: 

• Reviews and ensures the accuracy of billing information entered into the system.
• Review and resolve system edits prior to claim submission.
• Submits timely and accurate behavioral health claims.
• Utilize software knowledge, business processes knowledge and Standard Operating Procedures to correctly manage billing information.
• Analyze, monitor and measure the quality of billing information in accordance with data standards, policies and procedures and initiate appropriate action plans to correct errors.
• Act to resolve all billing issues and discrepancies.
• Maintain patient confidentiality as per the HIPAA guidelines.
• Comply with all applicable Federal, State and local laws, regulations, and requirements as well as CBI policies and procedures in all aspects of job performance
• Participate in various company, department and information services projects as assigned
• Meet or exceed department standards for production and quality.
• All other duties and responsibilities as assigned

MINIMUM EDUCATION & EXPERIENCE REQUIRED

• High School diploma, Associate Degree preferred. 
• 18 months experience with billing medical claims, behavioral claims knowledge is a plus.
• Billing certificate preferred.
• Equivalent combination of education, training, and experience

LICENSES, CERTIFICATIONS, CREDENTIALS, REGISTRATIONS

• Valid AZ Driver’s License in good standing and clear 39 month MVR. 

OTHER SKILLS AND KNOWLEDGE REQUIRED

• Minimum 18 months experience performing healthcare reimbursement, behavioral health insurance/billing or related work.
• Working knowledge of medical terminology.
• Customer service skills with the ability to work in a team environment.
• Minimum 18 months experience working with healthcare reimbursement systems.
• Must be highly organized and detail-oriented. Ability to work in a fast paced, rapidly changing environment.
• Experience in MS Word, Excel and Outlook.
• Must be able to type at least 40 WPM and possess a high school diploma or equivalent.

COMPLEXITY AND SCOPE OF POSITION

• Demonstrates knowledge and competency to submit claims meeting payer guidelines. Must obtain and apply payer requirements for authorizations, timely filing, and other payer specific edits. 

CBI Offers an excellent benefits package!

• Medical, Dental, Vision, Disability, Life, Supplemental plans - Hospital indemnity/ Critical Illness, Pet Insurance, Dependent Care Savings, Health Care Savings, 401K with employer match - 100% vested upon enrollment, Generous PTO accrual, Wellness programs, Tuition Reimbursement and Scholarship Programs, incentives, and more!
• For the past four years, The Phoenix Business Journal has recognized CBI as one of the top ten healthiest mid-size employers in the Valley.

CBI treats patients from all different walks of life and believes in maintaining the dignity of human life. Recovery is possible!