Administrative Assistant / Lead Billing & Data Specialist / Compliance & Policy Specialist
Vernon, AZ
Full Time
Experienced
Administrative Assistant,
Lead Billing and Data Specialist, Compliance & Policy Specialist
Administrative Assistant duties include assisting the Administrative Director with all aspects of licensing, license compliance, and insurance contracts including renewal and updating of current licenses and insurance contracts. Included are the collection of data and tracking KPIs (Key Performance Indicators).
This position also includes being the Lead Billing Specialist which duties include all aspects of the billing process, including properly completing the claim forms, tracking claims, following up on denied claims, maintaining systems that provides the status and upkeep of all claims, and the receiving of funds. Duties may include but are not limited to review and analysis of billable events from the EMR, transferring billable events to the insurance portal and follow through to completion. Included are duties of tracking all company KPI’s, such as compiling, reviewing, analyzing and formatting them and preparing them for review.
Specifics are as follows:
PREFERRED QUALIFICATIONS:
Lead Billing and Data Specialist, Compliance & Policy Specialist
Administrative Assistant duties include assisting the Administrative Director with all aspects of licensing, license compliance, and insurance contracts including renewal and updating of current licenses and insurance contracts. Included are the collection of data and tracking KPIs (Key Performance Indicators).
This position also includes being the Lead Billing Specialist which duties include all aspects of the billing process, including properly completing the claim forms, tracking claims, following up on denied claims, maintaining systems that provides the status and upkeep of all claims, and the receiving of funds. Duties may include but are not limited to review and analysis of billable events from the EMR, transferring billable events to the insurance portal and follow through to completion. Included are duties of tracking all company KPI’s, such as compiling, reviewing, analyzing and formatting them and preparing them for review.
Specifics are as follows:
- Maintains and updates yearly license with AZDHS
- Helps develop Corrective Action Plans (CAP) for licensure
- Applies for new medical insurance contracts with applicable insurance companies.
- Conducts research and provides guidance and data to others
- Coordinate tracking and reporting of all Key Performance Indicators (KPI) data.
- Analyze documentation and associated KPI data to show organizational success levels.
- Pulls EMR (KIPU) reports, reviews for errors, and compiles quarterly KPI reports
- Submits KPI reports to Administrative Director for Review and Approval, on time each month.
- Meets assigned deadlines and communicate status with Administrative Director
- Assists with development of Billing and KPI data tracking and reporting SOPs; provides suggestions for improvement
- Oversees billing tasks to include oversee of billing staff.
- Claims submissions, tracking of unpaid claims, and appeal of denied claims including AHCCCS denied claims we think we can successfully resubmit documentation to receive payment.
- Prepares Reconciliation Reports for each EFT payments received
- Researches and provides recommendations for billing codes and rates to optimize organizational profits.
- Seek to attain a consistent 99% clean claim rate
PREFERRED QUALIFICATIONS:
- Three + years of medical billing/support experience.
- Three + years of supervisory/management experience.
- Three + years of data collection, analysis, and reporting including experience developing and/or supporting organizational continuous improvement plans.
- AHCCCS Payor experience preferred
- Knowledge of business software including word processing, spreadsheets, and application presentations.
- Knowledge of Health Care EMR Systems – Prefer experience with KIPU
- Exceptional verbal and written communication skills to be utilized in interfacing with all levels of management.
- Excellent organizational skills and ability to manage multiple and diverse priorities simultaneously, meeting deadlines as required.
- Ability to handle highly confidential information.
- Ability to exercise independent judgment.
Apply for this position
Required*