Claims Specialist

Overview

Jewish Family and Children’s Service’s (JFCS) values each and every talented applicant, regardless of religious beliefs, race, age, origin, gender, sexual orientation, or cultural background. JFCS places a high value on inclusion and diversity, whether that applies to our employees or the nearly 40,000 clients receiving our services throughout the Valley.

 

Claims Specialist: The Claims Specialist processes claims and billing statements for the organization, provides all necessary follow-up on outstanding claims and statements, posts all third-party payments & client payments from statements, posts all claim denials and researches and follows-up to resolve denied claims.

 

This position researches and follows-up on client questions regarding statements, updates the billing system with changes to insurance information, and notes progress on researching and resolving denied claims. 

Responsibilities

• Processes all AHCCCS, RBHA, Medicare, commercial insurance and ALTCS claims following required procedures; provide all necessary follow-up including collections on outstanding claims.
• Processes all client statements, researches and follows up on client questions regarding statements.
• Posts all third-party payments, denials and adjustments; posts client payments resulting from statements.
• Researches and follows up to resolve denied claims, makes notes in the billing system to document the progress of denied claim follow-up efforts.
• Updates the billing system with changes to client insurance information and enters necessary alerts for the Operations staff on changes to insurance information and/or co-pay status of clients.
• Prepares all necessary financial reports and information for accounting department and CFO/COO.
• Communicates and coordinates effectively with internal and external contacts in a professional and timely manner to resolve billing and claims issues.
• Participates in Quality Improvement efforts.

Qualifications

• Verifiable High school diploma or equivalent accredited GED
• One year of billing and/or collections experience highly desirable.
• *Experience with Primary Care billing is very much preferred.
• Experience with NextGen preferred.
• Ability to acquire a Level 1 Fingerprint Clearance Card without Restriction(s).

Benefits of Working with JFCS:

• Bonus Programs for both full-time and part-time employees.
• Remote/Hybrid work opportunities.
• FREE Primary HealthCare to all employees and every member of their household, regardless of relationship. This includes virtual doctor's visits, physicals, lab tests, x-rays, vaccinations, prescriptions, and telehealth.
• Generous Employee Referral Bonuses for both the new-hire and the referring employee.
• Bilingual (Spanish-English) Pay Differential.
• Flexible Scheduling and Telehealth Flexibility for many positions.
• 401(k) Retirement Plan, with Company Match
• We offer tuition and clinical license reimbursement.
• Numerous professional development and career growth opportunities.
• Generous paid time off / sick time allocations
• Comprehensive Employee Benefits package, including medical, vision, dental, & more.
• Wellness Coaching
• Employee Assistance Program
• Eligibility for Loan Forgiveness Programs in many positions.