Under general supervision, this position is responsible for examining, verifying, and maintaining data related to processing medical care claims for alternate resources reimbursement and other third-party billing duties. The primary responsibility is to bill and process medical care claims in a timely manner to ensure reimbursement from third-party payers.
The role involves reviewing medical claims for accuracy and completeness, obtaining missing information, preparing and submitting claims, correcting rejected or suspended claims, maintaining billing records, and providing support for claims processing and coding issues. The position also includes work related to CPT/HCPCS coding, charge capture, compliance, provider file maintenance, insurer file updates, and coordination with patient registration and other departments.
This role may require temporary relocation to other TONHC facilities, including Sells Hospital, Santa Rosa Health Center, San Simon Health Center, and San Xavier Health Center.
Minimum Qualifications
- High School Diploma or General Education Diploma.
- Two years of work experience in medical billing, third-party billing, accounting, budget, financial management support, or an equivalent combination of experience.
Licenses, Certifications, and Special Requirements
- Must type 40 WPM.
- May require a valid driver's license.
- Must pass a criminal background check, FBI fingerprint check, and 39-month driving record review if hired.
- May need to meet tribal employer insurance requirements to operate program vehicles.
- May be required to demonstrate fluency in both the Tohono O'odham language and English.
Knowledge, Skills, and Abilities
- Knowledge of medical billing, claims processing, reimbursement, and revenue cycle procedures.
- Knowledge of ICD-10 and CPT/HCPCS coding procedures.
- Knowledge of HIPAA, privacy requirements, and compliance regulations.
- Familiarity with RPMS and third-party billing systems.
- Strong communication, customer service, typing, computer, and organizational skills.
- Ability to analyze complex medical and regulatory information, meet deadlines, work independently, and maintain confidentiality.
Location
Tucson, Arizona, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 month ago