Eligibility specialist jobs in Phoenix, Arizona - Page 2Create job alerts

Job DescriptionDescription: We are rapidly growing leader in the provision of clinical respiratory equipment, DME and service that is seeking outstanding individuals to join our team of professionals. Due to our success, we are constantly looking for talented and qualified candidates. Position: Billing Specialist Branch: Valley Seating and Mobility, a subsidiary of Quipt Home Medical Job Summary: Ideal candidates will preferably have prior experience, all necessary license and credentials, a record of accomplishment, a history of reliability, and an expectation of providing outstanding service to our customers. The purpose of the DME Billing and Account Receivables Specialist is initiate billing claims, actively process all denials and ensure follow up on the collection efforts to ensure timely reimbursement for services provided. Let’s start with what’s important to you. The Benefits..... • Medical Insurance- multiple plans to choose from, • Dental & Vision Insurance, • Short Term Disability & Long Term Disability Options, • Life Insurance, • Generous PTO plan, • Paid Holidays, • 401K, • 401K match, • Ability to read and understand medical terminology., • Review clinical documentation to ensure compliance with Medicare guidelines., • Verify payor source and insurance eligibility., • Validate ICD-9/10 codes as appropriate for product dispensed., • Ability to apply correct modifier and HCPCS to claims., • Submit accurate claims utilizing Brightree billing software., • Reconcile billing errors on a daily basis., • Complete CMS 1500 claim forms as required., • Manage account receivables to maintain payments within 90 days., • Adhere to monthly closing timeline requirements., • Maintain excellent communication with company management and co-workers., • Attendance at all meetings, conference calls, etc. at the discretion of your manager., • Must be computer literate and possess the ability to acquire working knowledge of all pertinent software related to DME., • Maintain compliance with all federal, state and local government regulations and agencies., • High School Diploma or equivalent., • Medical coding and/or billing certification preferred but not required., • Prior experience preferred but not required. Patient Aids is willing to train candidates that exhibit the desired qualities., • Ability to pass a Federal background check., • Must be able to work independently and within a team environment., • Must possess excellent interpersonal, coordinating and organizational skills., • Have the ability to manage multiple tasks simultaneously., • Read, write, speak and understand the English language and possess good communication skills., • Must possess the ability to make independent decisions when circumstances warrant such action. Job Type: Full-time

Job Description A positive future for every child Southwest Human Development is Arizona’s largest nonprofit dedicated to early childhood development. The first five years of life are the most critical in a child’s development. At Southwest Human Development, our services improve lives and help families by supporting young children and their caregivers during this important time. Your skills, experience, and passion are needed at one of the nation’s largest nonprofits dedicated to early childhood development. Join our team and experience a long-term career that brings joy and satisfaction in knowing you make a difference. We offer over 40 programs and services to more than 140,000 children. Why choose us? • You will be rewarded with benefits, including zero contribution health plan options, 401K plan, wellness programming, and generous paid time off., • You will have the opportunity to represent a highly respected non-profit agency in Arizona. We seek a bilingual (English/Spanish) Administrative PA Specialist for our Health and Developmental Services Department – Birth to Five Center of Excellence. This position is responsible for diverse administrative duties, including answering phones, customer service, checking in clients, responding, and following up on clients’ insurance billing questions. In addition, the individual will be responsible for verifying medical insurance eligibility, obtaining insurance benefits for clients, and ensuring prior authorizations for services are completed in a timely manner. Working with the other Administrative Assistants to accomplish administrative duties within the program. Other duties may include verbal and written translation, filing, database entry, copying, faxing, maintaining EMR files, etc. This position works out of our main office from Monday to Friday and the hours from 8 am to 5 pm. Duties Include: Greet and welcome families to the clinic and connect them with their service. Assist with Pre-Authorizations (PAs) for clients' insurance benefit levels; contact and receive verification of benefits from insurance companies to make sure the necessary authorization for services is obtained. Communicate with families in regards to explanation of benefits(EOB) regarding copays, co-insurance, and deductibles and documenting the appropriate information in the client's EMR record. Assist with tracking the status of PAs on a daily basis and serves as a resource for clinical staff to facilitate timely completion. Follows up and contacts referral sources, pediatrician offices and other community professionals for any additional information needed to process the PAs Assist with reviewing and reconciling data for billing purposes Translate and interpret documents written in English to Spanish Respond to emails, faxes, and requests on time as established by program guidelines. Collaborate with supervisor and other team members on special projects. Qualifications • High School diploma / GED, • Minimum 2 years of billing/ medical insurance experience required, • Bilingual – ability to speak, read, and write (English/Spanish) fluently., • Two (2) years of experience working in an office setting., • Proficiency with Microsoft Office (MS) 365 and other MS Office applications, such as Word, Excel, and PowerPoint., • Effective interpersonal and written communication skills., • Comfortable on the phone and can multi-task in a fast-paced environment., • Effective interpersonal and written communication skills. Our core values embody Southwest Human Development’s commitment to services that uplift the lives of children, families and other care providers, and the communities in which they live. These values are intended to guide the professional development, ethical conduct, and skilled practice of all our staff, whatever their specific role within the agency. All staff are valued as making essential contributions to strengthening the foundation that Arizona’s children need for a great start in life. Learn more about our values and benefits here.

Job DescriptionDescription: The Front Office Specialist will be committed to assisting patients and providing high quality service in a kind and caring manner with a family centered approach to their care. Participate in any staff meetings and assist with problem identification, solution, and implementation of change. Be an active team participant and foster a work environment based on inspired, passionate care and impeccable interpersonal communication, collaboration, immediate and effective conflict resolution with others. Essential Job Functions: • Contact insurance companies to verify patient benefit coverage/medical policy information and to obtain prior authorization for medical services. Collect copayments, deductibles and coinsurances from patient at time of appointment. Assist patient with financial assistance applications when applicable., • Enter/transfer billing coding from patient charts into EMR after each treatment if not already in the system., • Provide information such as policies, procedures and other items to patients and others. Transfer calls and take messages; assist patients in completing forms and documents., • Schedule patient appointments accurately, route and receive paper and electronic documents; collect and process payments for patient services. Conduct banking duties to include physical deposits., • File information consistent with company procedures; alphabetically, numerically, and/or chronologically. Maintain organized and accurate filing systems; locate and retrieve files manually or electronically to provide requested information per company policy; create new files, merge files, and purge old files according to established policy and procedures; update and correct patient information to maintain accuracy while always adhering to HIPAA rules and regulations., • Prepare daily bank deposits, scan and send created documents to accounting staff per procedure protocol. Complete daily deposit tracking worksheet. Sort and distribute mail to department employees at their locations, • Assist with new insurance plan credentialing by completing the required application and obtaining all plan requirements., • Provide excellent customer service to all individuals and ensure patient/customer satisfaction at all levels of interaction., • Maintain compliance with the local, state and federal laws., • Adhere to all company policies and procedures carefully and properly., • Assist with other projects assigned including off-site educational presentations, fairs or exhibitions., • Must be highly responsible and encompass secure organization skills., • Graduation from high school or possession of a G.E.D. certificate, and one year of general clerical experience; or,, • Must have 1-2 years' experience in front office medical processes including scheduling, verification of benefits, and authorizations., • A combination of training, education, and experience equivalent to the employment standards listed above provides the required knowledge and abilities., • Medical Assistant certification is a plus., • Bi-lingual is a plus. Knowledge of: Patient charts and medical history; medical terminology, general terminology of ICD -10 and CPT codes; English, grammar, punctuation, and spelling; basic math, basic clerical office practices and procedures; filing methods; telephone procedures, including operation of multi-line equipment, message taking, business telephone etiquette, Microsoft Office programs (Word, Excel, PowerPoint) and EMR systems. Ability to: Deal tactfully with people at all levels; tolerate stress; solve problems using proper judgment; maintain confidentiality of information; write legibly to record information; prepare simple correspondence; understand and follow oral and written instructions; read and understand manuals; verbally communicate information clearly and concisely to others; operate office equipment such as personal computer, typewriter, printer, scanner, copier, and fax machine; organize and prioritize work; proofread documents and correspondence; file information alphabetically, numerically, and chronologically; work well with other office staff members to complete daily tasks. Additional Requirements: May require typing ability, including a minimum typing speed. Conditions of Employment: • Acceptance of Employment Offer, • Completed Company Employment Paperwork, • Employment Eligibility Check, • Drug Test Passed, • Reliable Transportation, • Embrace Organization’s Core Values

Job DescriptionBenefits: • Bonus based on performance, • Opportunity for advancement, • Paid time off, • Signing bonus, • Competitive salary, • Flexible schedule We look forward to incorporating your energy and marketing perspective into our team as we build success together. RESPONSIBILITIES: • Establish customer relationships and follow up with customers, as needed., • Provide prompt, accurate, and friendly customer service. Service can include responding to inquiries regarding insurance availability, eligibility, coverages, policy changes, transfers, claim submissions and billing clarification., • Use a customer-focused, needs-based review process to educate customers about insurance options., • Use exemplary communication to efficiently meet the needs of customers while promoting the development of our business.QUALIFICATIONS:, • Dedicated to customer service, • Able to obtain a Life/Health License, • Able to achieve mutually agreed upon marketing goals, • Interested in marketing products and services based on customer needsBENEFITS:, • Salary plus commission/bonus, • Paid time off (vacation and personal/sick days), • Health benefits, • Growth potential/Opportunity for advancement within my office

Job DescriptionAbout Optima Medical Optima Medical is an Arizona-based medical group consisting of 30+ locations and over 130+ medical providers, caring for more than 200,000 patients statewide. Our mission is to improve the quality of life throughout Arizona by helping communities "Live Better, Live Longer" through personalized healthcare, with a focus on preventing the nation’s top leading causes of death. We go beyond primary care with a full spectrum of services including cardiovascular health services, behavioral health, allergy testing and immunotherapy, in-house lab testing, imaging, chronic disease management, and other specialty health services. We aspire to aid the growth of our company by welcoming the most qualified and deserving candidates aboard. We are seeking a Charge Entry Specialist to join our Revenue Cycle team and support the accurate and timely processing of patient claims across our expanding network of primary care clinics. Job Responsibilities: • Oversee daily data entry team and complete reconciliation of charge batches entered, • Maintain organized records of charges and batches, both entered and pending entry, • Review and assist with performing claim edits ie: ICD to CPT mapping, updating modifiers, CPT crosswalks, and claim submissions, • Review medical records and documentation for coding accuracy and completeness; review for errors & inconsistencies ensuring all billing is documented, captured, and submitted to insurance by timely filing limits, • Work closely with office managers, coders, and other billing members to resolve claim discrepancies, • Review and update patient demographics and insurance information as needed based on eligibility, • High School Diploma or GED required, • A minimum of 2 years' experience in medical billing, preferably in a primary care setting, • Experience with electronic health records (EHR, eClinicalWorks preferred!), • Knowledge of CPT, ICD-10, HCPCS & medical terminology, • Excellent computer skills, detail oriented, and ability to multitask effectively, • Ability to work independently and as part of a team in a fast-paced environmentWhy Join Our Team?, • Supportive and positive team culture, • Leadership and mentoring to support career growth, • Full benefits package (Medical / Dental / Vision / 401k / Paid Holidays), • Fun team events and appreciation initiatives

Job Description As a Commercial Lines Insurance Nonprofit Human Services Underwriting Specialist, you will be responsible for growing and managing a book of commercial lines business, including responsibility for advising other underwriters and support staff on processes and procedures and consulting at the highest level of technical underwriting authority. You will be analyzing and assessing exposures and acceptable risks for our Nonprofit Human Service Organizations and Education Institutions to determine coverages and premium that are both adequate and competitive. As a Nonprofit Human Services Underwriting Specialist you will build successful relationships with agents to drive increased, positive business flow. You will work under limited supervision and exercises significant independent judgment in performing work. Accounts vary in size, but may include accounts up to $1,000,000 in written premium. Accountabilities: • Delivers profitable outcomes and growing a portfolio of complex niche business through effective risk selection by:, • Analyzing, selecting and profitably pricing business with prescriptive terms and conditions of coverage., • Examining inspection reports, location, risk, financial and other available tools and reports to identify new or unresolved concerns., • Communicating with Risk Control for inspections, follow ups and service needs for insureds., • Driving corrective action or remediation strategies on renewal accounts., • Underwrite renewals referred by the underwriting assistant as well as renewals over 35K working to achieve required rate changes goals as outlined by management. Discuss and issue nonrenewals as needed., • Escalating referrals, in a timely manner, on accounts that need additional review or approval by higher level underwriters., • Adhering to service expectations and regulatory compliance by the timely release of renewals, non-renewals and conditional notices., • Accountable for achieving key performance indicators of the portfolio including:, • Developing and furthering successful relationships with distribution partners within the portfolio by:, • Having regularly scheduled portfolio review calls., • Meeting service standards for quality and timeliness., • Limited travel to distribution partner offices., • Coordinating with distribution team to build pipeline, resolve issues, concerns or conflict and oversee change management., • Communicating regularly with portfolio team members on health of assigned agencies and market conditions that could impact the portfolio., • Develop and grow agency relationships through daily interactions and in person visits throughout the year; collaborate with the distribution team on cultivating agency relationships and new business opportunities., • Cultivate a High Performing Culture, • Superior customer service and business acumen., • Mentoring support staff throughout their career development., • Conduct peer audits., • Assist in the training of new hires and internal promotions by providing continuous mentoring and feedback to foster successful employee development., • Reviewing, mentoring, and approving referrals for lower authority level associates., • Perform other related work as assigned. Qualifications: • Bachelors Degree or equivalent work experience., • 5+ years underwriting all commercial lines (Commercial Property, General Liability, Professional Liability, Worker's Compensation, Crime, Commercial Auto, Umbrella, etc)., • Prefer Nonprofit Human Services and Education underwriting experience., • Excellent communication skills both in writing and verbal, • Ability to analyze and make decisions in a timely manner, • Working to obtain or has already CPCU or other industry equivalent Compensation: • $88,200 - $147,000 commensurate with experience, plus bonus eligibility, • $97,200 - $162,000 commensurate with experience in CA, CT, MA, NJ, NY, and PA, plus bonus eligibility Benefits: We are proud to offer a robust benefits suite that includes: • Competitive base salary plus incentive plans for eligible team members, • 401(K) retirement plan that includes a company match of up to 6% of your eligible salary, • Free basic life and AD&D, long-term disability and short-term disability insurance, • Medical, dental and vision plans to meet your unique healthcare needs, • Wellness incentives, • Generous time off program that includes personal, holiday and volunteer paid time off, • Flexible work schedules and hybrid/remote options for eligible positions, • Educational assistance #TMG

Job Description About the Role We are seeking a Billing & Settlement Specialist (Mid to Senior level) to join our finance and accounting team. This role is responsible for managing accounts receivable (AR), accounts payable (AP), and expense management to ensure accurate billing, timely payments, and financial compliance. The ideal candidate will be bilingual in Korean and English, detail-oriented, and experienced in AR/AP processes within a settlement or accounting environment. Requirements Key Responsibilities Accounts Receivable (AR) – Billing & Collections • Review billing data from Operations to ensure all applicable charges are invoiced., • Verify billing accuracy against tariff rates and contracts., • Process billing through internal settlement systems (EDI) or manual invoicing., • Monitor AR aging reports and follow up on outstanding payments via phone and email. Accounts Payable (AP) – Vendor Payments • Review, organize, and process vendor invoices for payment., • Verify supporting documents (Manifests, POD/EIR) for accuracy., • Ensure proper pay rates are applied, including rating adjustments., • Resolve billing disputes with vendors to ensure charges align with contracted rates. Expense Management & Reporting • Manage expense processing and post entries into the accounting system., • Support month-end and quarter-end closings, including accruals and reconciliations., • Maintain vendor communications to keep accounts current., • Perform regular audits to identify and resolve discrepancies. Qualifications • 3+ years of experience in Accounts Receivable, Accounts Payable, or Settlement., • Bilingual proficiency in Korean and English – required., • Strong attention to detail and organizational skills., • Ability to manage multiple tasks and meet deadlines., • Service-oriented mindset with strong communication skills., • Proficiency in Microsoft Excel and Word (advanced Excel skills preferred). Benefits Benefits • Health, Dental, and Vision PPO Insurance, • Life, Short-Term Disability (STD), and Long-Term Disability (LTD) Insurance, • 401(k) Retirement Plan, • Paid Time Off (PTO), • Additional Leave (Bereavement, Wedding, Childbirth, etc.), • Years of Service Awards, • Education Assistance Program (based on eligibility)