AHCCCS

Arizona Health Care Cost Containment System
Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Courage, Teamwork

The Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid agency, is driven by its mission to deliver comprehensive, cost-effective health care to Arizonans in need. AHCCCS is a nationally acclaimed model among Medicaid programs and a recipient of multiple awards for excellence in workplace effectiveness and flexibility.

AHCCCS employees are passionate about their work, committed to high performance, and dedicated to serving the citizens of Arizona. Among government agencies, AHCCCS is recognized for high employee engagement and satisfaction, supportive leadership, and flexible work environments, including remote work opportunities. With career paths for seasoned professionals in a variety of fields, entry-level positions, and internship opportunities, AHCCCS offers meaningful career opportunities in a competitive industry.

Come join our dynamic and dedicated team.

Address: 150 N. 18th Avenue Phoenix, AZ 85007

IN OFFICE POSITION

Salary: $33,500 ($16.1058 Hourly)

Grade: 15

FLSA Status: Non-Exempt

First Review of Resumes: June 19, 2026

Closing Date: June 23, 2026

This position reports to the Medical Records Manager and is responsible for transferring data from paper formats into computer files or database systems. The transfer of data happens manually or using AHCCCS Optical Character Recognition (OCR) claim system. They type and verify all claim information as submitted by the provider to ensure timely claim processing.

This position is responsible for processing claims that are pended and have to be adjudicated per agency policies and procedures. The position requests medical documentation from providers, looks for consent forms, reviews the history for duplicates or duplicate payments, ensures the system is appropriately processing claims, and identifies inappropriate billing patterns, when are then reported to our audit unit or to the agency's Fraud Unit for review. The position looks for third party liability, and ensures that the documentation needed is included with submissions. The position reprocesses Prior Authorization claims, supplements and links documentation, and recoups and voids claims. This position is also responsible for multiple special projects related to claims processing and adjudication.

This position also performs statewide research in systems regarding records. Turning paper documents into a digital copy using scanning equipment. Duties typically include managing and storing files on a computer, raising concerns and issues with the scanning equipment to technicians, and inspecting the quality of output regularly. Daily task assignments are based on immediate business needs.


Major duties and responsibilities include but are not limited to:
• Accurately input a high volume of data from multiple sources into a database, ensuring that all necessary data is being entered as submitted by the provider. Entering data by a manual process and /or correcting fields and completing missing key fields in an Optical Character Recognition (OCR) system.
• Entry and transcribing from paper formats into computer files of medical claims, form types CMS 1500s, UB04s, and ADA Dental Forms while meeting established quality and production standards.
• Processes claims that are pended (adjudicates); including requests medical documentation from providers, looks for consent forms, EOBs and Third Party Liability, reviews the history for duplicates or duplicate payments, identifies inappropriate billing patterns and forwards to appropriate unit, ensures medical documentation is included with submissions, supplements and links documentation, recoups and voids claims.
• Ensure the system is appropriately processing claims, identifies problems/issues and notifies appropriate parties for resolution, identifies inappropriate billing patterns which are then reported to the Audit Unit or to the Agency's Fraud Unit for review. Verifies eligibility of claims, using agency's policies and procedures, coordinates claims that have Third Party Liability. Re-processe