GENERAL DESCRIPTION OF RESPONSIBILITIES:
Under general supervision, adjudicates behavioral health, medical claims entered into the CPI EHR system for all lines of business. Reviews and resolves rejected, pended and/or denied encounters within the claims system timely. Organizes claim and encounter data and prepares various claims/encounter reports; conducts research and analyses of encounter and claims data; facilitates resolution of specific claims and encounter issues; serve as liaison to internal department, payers and external agencies.
Training or experience equivalent to a bachelor’s degree plus three years experience in claims analysis and adjudication of medical claims, including Medicare and Third Party Liability. Experience with ICD10, CPT, HCPCS and UB04 coding and billing and knowledge of HIPAA regulations is required. Advanced knowledge of Microsoft Excel and 10-key by touch is also required.
Location: Tucson, AZ
CPI is an equal opportunity employer. CPI does not discriminate based on age, ethnicity, race, sex, gender, religion, national origin, creed, tribal affiliation, ancestry, gender identity, sexual orientation, marital status, genetic information, veteran status, socio-economic status, claims experience, medical history, physical or intellectual disability, ability to pay, source of payment, mental illness, and/or cultural and linguistic needs, as well as any other class protected by law.