AHCCCS Medical Claims Examiner & Eligibility Support

Pima County; United States; On-site; USD 31,000 - 42,000; Full time

Job summary

Pima County's Detainee & Crisis Systems is hiring a Medical Claims Examiner at the Adult Detention Center to review and process Medicaid/AHCCCS medical claims, verify documentation, and ensure adherence to policies. The role requires accuracy, data entry, and reporting to improve eligibility processes and access to healthcare benefits for individuals in custody.

The position offers competitive hourly pay, a comprehensive benefits package, and opportunities to contribute to program efficiency

Qualifications

• Three years of work experience in processing or billing medical claims.
• OR: Two years of work experience with Pima County preparing, processing, or billing medical claims or accounting documentation.

Responsibilities

• Reviews, verifies, and processes medical claims documentation for accuracy and adherence to policies.
• Responds to inquiries from medical providers and outside agencies; explains County rules and policies.
• Performs pre- and post-payment review of claims for accuracy and adherence to procedures.
• Compiles statistical data and prepares reports on claims activity.
• Processes payments for medical claims and resolves discrepancies with departments and outside agencies.

Skills

Medical claims processing

AHCCCS eligibility

Attention to detail

Data analysis

Tools

Microsoft Office Suite

Electronic databases

Job description

Pima County's Detainee & Crisis Systems is hiring a Medical Claims Examiner at the Adult Detention Center to review and process Medicaid/AHCCCS medical claims, verify documentation, and ensure adherence to policies. The role requires accuracy, data entry, and reporting to improve eligibility processes and access to healthcare benefits for individuals in custody.

The position offers competitive hourly pay, a comprehensive benefits package, and opportunities to contribute to program efficiency