Claims Support Specialist

Job Full Description

Overview
We are seeking a detail-oriented and driven Behavioral Health Claims Specialist / Medical Biller to join our team. This role supports the day-to-day operations of the claims department by gathering information, processing high-volume behavioral health and psychiatric healthcare claims, and ensuring accurate and timely reimbursement. The ideal candidate is highly skilled in Medicaid AHCCCS Plans, thrives in a fast-paced environment, and is passionate about maximizing collections while maintaining compliance and accuracy.

What You'll Do

• Verify insurance eligibility for behavioral health services.
• Scrub, batch, and file claims for accuracy, completeness, and compliance.
• Reconcile electronic 837 transactions, payment files, and ensure claims are worked through to completion.
• Troubleshoot denied or delayed claims with payers; analyze, research, and resubmit as needed.
• Post payments and reconcile accounts to ensure accuracy.
• Regularly correspond with insurance companies regarding outstanding or denied claims.
• Maintain strict confidentiality of all claims and participant information.
• Collaborate with internal teams to ensure proper documentation, coding, and billing practices.
• Work toward and consistently achieve monthly collection goals.
• Monitor appeals and reimbursement

Requirements

• High School Diploma or equivalent required; Associate's degree in Medical Billing & Coding, CPC certification, or equivalent experience strongly preferred.
• Minimum of 1-2 years' experience in a healthcare claims or billing setting, with behavioral health experience preferred.
• Proven experience with Medicaid AHCCCS Plans and high-volume claims processing.
• Proficiency in Microsoft Excel (assessment required).
• Experience with EHR and computerized billing functions; Credible Billing Software experience a plus.
• Familiarity with electronic billing systems (837 transactions) and payment reconciliation.
• Valid Driver's License and acceptable three-year Motor Vehicle Record.
• Valid Fingerprint Clearance Card or ability to obtain within 90 days of hire.
• Not ideal for candidates with primarily manual entry billing backgrounds.

What We're Looking For

• Strong problem-solving skills and persistence in pursuing payment.
• Highly organized with excellent attention to detail.
• Effective communicator with both internal staff and insurance representatives.
• Ability to work independently while thriving in a high-volume, fast-paced environment.
• Passion for getting payments collected and driving results.

Our Perks:

• Exceptionally generous PTO (3.5 weeks off your first year and rising in subsequent years)
• 14 paid holidays
• 403(b) with company match
• Medical/Dental/Vision insurance
• Voluntary short and long term disability insurance
• Life insurance
• Employee assistance program
• Voluntary insurance for critical illness, accident and hospitalization
• Pet insurance

#2107

Peoria, AZ
2107
8345 West Thunderbird Road
Suite B-107
Peoria, AZ 85381