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CLAIMS SPECIALIST

Posted on Feb 14, 2019 by COMMUNITY PARTNERS INTEGRATED HEALTHCARE

Tucson, AZ 85701
Insurance
30 Jan 2019
Annual Salary
Full-Time
At Community Partners, Inc.; our core focus is providing improved health for our community through high quality behavioral health care services. Our team has served the mental health needs of the Tucson community for over 20 years, formerly as Community Partnership of Southern Arizona. We have also developed business, consulting and supportive services (such as housing programs) that benefit the people we serve as well as other nonprofits, organizations, government departments and health plans. We are currently looking for a qualified Psychiatric Registered Nurse to join our dedicated team in Tucson! 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. MINIMUM QUALIFICATIONS: Training or experience equivalent to a bachelor's degreeMinimum 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 requiredMust possess or be able to obtain a Level I Fingerprint Clearance Card Must pass pre-employment drug screening SUPERVISORY AUTHORITY: The Claims Specialist is supervised by the Director, IS FLSA STATUS: Non-Exempt 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. Category: Insurance , Keywords: Insurance Case Manager

Reference: 646340248