Medical Policy Specialist jobs in Mesa, AZ

Optima Medical is an Arizona-based medical group consisting of 15 locations and 70 medical providers, who care for more than 120,000 patients statewide. Our mission is to improve the quality of life throughout Arizona by helping communities “Live Better, Live Longer” through personalized healthcare, with a focus on preventing the nation’s top leading causes of death. We go beyond primary care with a full spectrum of services including cardiovascular health services, behavioral health, allergy testing and immunotherapy, in-house lab testing, imaging, chronic disease management and other specialty health services. We aspire to aid the growth of our company by welcoming the most qualified and deserving candidates aboard! Optima is currently seeking a Charge Entry Clerk to join our team!

*Our Charge Entry department is responsible for tracking, auditing, reconciling, editing, and submitting all primary & secondary claims. This entails checking the status of outstanding physician charges/notes and pulling reports of completed superbills. Review for errors and inconsistencies; ensuring all billing is documented, coded, captured, and submitted to insurance by timely filing limits.  

*This is not a remote or hybrid role*

Job Responsibilities:  

• Generate daily physician unlocked notes reports in EMR & update / track progress via Microsoft Excel spreadsheets to ensure accurate entry to EPM  
• Oversee daily data entry and complete reconciliation of charges/batches entered 
• Maintain organized records of charges and batches, both entered and pending entry
• Review and assist with performing claim edits ie: ICD to CPT mapping, updating modifiers, CPT crosswalks, and claim submissions  
• Review and assist with fee schedule updates  
• Review and update patient demographics and insurance information as needed based on eligibility  

 Job Qualifications: 

• A minimum of 2 years' experience in medical billing and systems; Primary Care & eClinicalWorks preferred!
• Physician billing experience is a must. 
• High School Diploma or GED required 
• CPT, ICD-10, HCPCS & medical terminology knowledge required  
• Excellent computer skills, detail oriented, and ability to multitask effectively 
• Positive attitude that welcomes teamwork 
• Full cycle billing is a plus! 
• Experience working with Microsoft Excel
  

Why join our team?

• Substantial growth opportunities
• Open to new grads!
• Leadership and mentoring
• Resources to further career
• Fun work environment (happy hours, lunches, events, holiday parties)
• Benefits (medical/vision/dental/401k/paid holidays)
• Supportive and positive work environment