Top 150 Medical claims processing Jobs in Phoenix, Az

Initial Clinical Reviewer - Remote - AZ
Blue Cross Blue Shield of Arizona —Phoenix, AZ
- Full-time
- LMFT
- Nursing
- RN License
BH UM Clinical Reviewer- Remote AZ
Blue Cross Blue Shield of Arizona —Phoenix, AZ
- Full-time
- Mid-level
- Organizational skills
- 1 year
4d
Health Services Technician (Justice Technician) - Remote AZ
Blue Cross Blue Shield of Arizona —Phoenix, AZ
- Full-time
- Mid-level
- 3 years
- Analysis skills
Medical Billing Specialist
Ronald McDonald House Central & Northern Arizona —Phoenix, AZ
- $28 - $32 an hour
- Full-time
- Microsoft Excel
- Mid-level
- Microsoft Office
- Health insurance
- Dental insurance
Quick Apply
8d
Financial Clearance Specialist
Dignity Health Medical Group —Phoenix, AZ
- $23.00 - $32.49 an hour
- Full-time
- Research
- Mid-level
- High school diploma or GED
2d
Surgical Authorization Specialist- Remote
The CORE Institute | HOPCo —Phoenix, AZ
- Remote
- Microsoft Outlook
- Surgery
- Computer literacy
Quick Apply
6d
Insurance Follow Up Representative
The CORE Institute | HOPCo —Phoenix, AZ
- Remote
- Research
- Mid-level
- High school diploma or GED
Quick Apply
RCM / Collections Specialist / Medical Biller - Remote - Pacific Time Zone
Option Care Health —Phoenix, AZ
- $20 - $22 an hour
- Full-time
- Remote
- Microsoft Word
- Computer literacy
- HIPAA
- Health savings account
- Health insurance
Insurance Follow Up/ Medical Biller
The CORE Institute | HOPCo —Phoenix, AZ
- Remote
- Research
- Mid-level
- High school diploma or GED
Quick Apply
Credentialing Coordinator - (Remote in Arizona)
Blue Cross Blue Shield of Arizona —Phoenix, AZ
- Full-time
- Mid-level
- High school diploma or GED
- Continuous improvement
Accounts Receivable Specialist
UNITED WOUND HEALING PS —Phoenix, AZ
- $24 - $27 an hour
- Overtime
- Microsoft Outlook
- Word processing
- Pass drug screening
- AD&D insurance
- Paid holidays
Quick Apply
Insurance Follow-Up Rep
The CORE Institute | HOPCo —Phoenix, AZ
- Remote
- Microsoft Outlook
- Customer service
- Computer literacy
Quick Apply
5d
Telehealth Medical Clinic Manager
Envita Medical Centers LLC —Scottsdale, AZ
- Full-time
- Master's degree
- Bachelor's degree
- Senior level
- Health insurance
- Dental insurance
Quick Apply
Sr Medical Biller
Community Medical Services —Scottsdale, AZ
- Full-time
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- Addiction Medicine
- Health savings account
- Paid holidays
Quick Apply
Medical Payment Poster
Regency Specialties —Surprise, AZ
- From $20 an hour
- 8 hour shift
- HIPAA
- Mid-level
- In-person
- Paid holidays
- Health insurance
Quick Apply
Orthopedic Technician
Select Ortho —Phoenix, AZ
- Full-time
- Anatomy knowledge
- Word processing
- Mid-level
Quick Apply
Sr. Clinical Coder
Cook Systems —Phoenix, AZ
- Remote
- Microsoft Word
- Microsoft Excel
- Research
- Health insurance
- Dental insurance
6d
Center Care Team - Medical Assistant, Bilingual
ArchWell Health —Sun City, AZ
- Full-time
- Vital signs
- Microsoft Outlook
- BLS Certification
4d
PATIENT FINANCIAL SERVICE REPRESENTATIVE
Gastro Care Partners —Phoenix, AZ
- $18 - $22 an hour
- Full-time
- Remote
- Medical office experience
- HIPAA
- High school diploma or GED
- Paid holidays
- Paid time off
Quick Apply
10d
In Office Position - Medical Billing Specialist
ANESTHESIA —Phoenix, AZ
- $25 - $30 an hour
- Full-time
- Mid-level
- Office
- In-person
- Health insurance
- Dental insurance
Quick Apply

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Initial Clinical Reviewer - Remote - AZ

Blue Cross Blue Shield of Arizona -
Phoenix, AZ

Apply Now

Job Details

Full-time

Qualifications

Customer relationship building
Copy machines
Employee relationship building
Medical records
Fax machines
Conflict management
Desktop applications
Clinical confidentiality policies
Faxing

Full Job Description

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.

At AZ Blue, we have a hybrid workforce strategy, called Workability, that offers flexibility with how and where employees work. Our positions are classified as hybrid, onsite or remote. While the majority of our employees are hybrid, the following classifications drive our current minimum onsite requirements:

Hybrid People Leaders: must reside in AZ, required to be onsite at least twice per week
Hybrid Individual Contributors: must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per week
Hybrid 2 (Operational Roles such as but not limited to: Customer Service, Claims Processors, and Correspondence positions): must reside in AZ, unless otherwise cited within this posting, required to be onsite at least once per month
Onsite: daily onsite requirement based on the essential functions of the job
Remote: not held to onsite requirements, however, leadership can request presence onsite for business reasons including but not limited to staff meetings, one-on-ones, training, and team building

Please note that onsite requirements may change in the future, based on business need, and job responsibilities. Most employees should expect onsite requirements and at a minimum of once per week.

This remote work opportunity requires residency, and work to be performed, within the State of Arizona.

PURPOSE OF THE JOB

Responsible for identifying, researching, processing, resolving, and responding to inquiries from internal and external customers with emphasis on excellence, privacy, compliance and versatility within the health insurance industry.

QUALIFICATIONS

REQUIRED QUALIFICATIONS

Required Work Experience

2 years of experience in clinical field of practice, health insurance, or other health care related field

Required Education

Associate’s Degree in general field of study or Post High School Nursing Diploma or Certification (LPN only) from an approved program

Required Licenses

Active, current, and unrestricted license to practice in the State of Arizona (or an endorsement to work in Arizona) as a behavioral health professional such as LCSW, LPC, LISAC LMFT, or licensed psychologist (Psy.D. or Ph.D.), OR an active, current, and unrestricted license to practice nursing in either the State of Arizona or another state in the United States recognized by the Nursing Licensure Compact (NLC) as an RN, OR an active, current, and unrestricted license to practice in the State of Arizona as an LPN.

Required Certifications

PREFERRED QUALIFICATIONS

Preferred Work Experience

3 years of experience in clinical field of practice, health insurance, or other health care related field

Preferred Education

Bachelor's Degree in Nursing or related field of study

Preferred Licenses

Active, current, and unrestricted license to practice in the State of Arizona (a state in the United States) as a Registered Nurse

Preferred Certifications

ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES

Identify, research, process, resolve and respond to customer inquiries and correspondence via telephone, written communication and/or in person.

Answer a diverse and high volume of health insurance related customer calls or correspondence on a daily basis.
Analyze medical records and apply medical necessity criteria and benefit plan requirements to determine the appropriateness of benefit requests.
Maintain complete and accurate records per department policy.
Meet quality, quantity and timeliness standards to achieve individual and department performance goals as defined within the department guidelines and required by State, Federal and other accrediting organizations.
Explain to customers a variety of information concerning the organization’s services, including but not limited to, contract benefits, changes in coverage, eligibility, claims, BCBSAZ programs, provider networks, etc.
Demonstrate ability to apply plan policies and procedures effectively.
Consult and coordinate with various internal departments, external plans, providers, businesses, and government agencies to obtain information and ensure resolution of customer inquiries.
When indicated to assist with team/project functions:
- Collaborate with team to distribute workload/work tasks;
- Monitor and report team tasks;
- Communicate team issues and opportunities for improvement to supervisor/manager;
- Support/mentor team members.
Participate in continuing education and current developments in the fields of medicine and managed care.
Maintain all standards in consideration of State, Federal, BCBSAZ and other accreditation requirements.
The position has an onsite expectation of 0 days per week and requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements

Perform all other duties as assigned.

COMPETENCIES

REQUIRED COMPETENCIES

Required Job Skills

Intermediate PC proficiency
Intermediate skill in use of office equipment, including copiers, fax machines, scanner and telephones

Required Professional Competencies

Maintain confidentiality and privacy
Strong current clinical knowledge
Practice interpersonal and active listening skills to achieve customer satisfaction
Compose a variety of business correspondence
Interpret and translate policies, procedures, programs and guidelines
Capable of investigative and analytical research
Navigate, gather, input and maintain data records in multiple system applications
Follow and accept instruction and direction
Establish and maintain working relationships in a collaborative team environment
Organizational skills with the ability to prioritize tasks and work with multiple priorities
Independent and sound judgment with good problem solving skills

Required Leadership Experience and Competencies

Resolve conflicts
Represent BCBSAZ in the community

PREFERRED COMPETENCIES

Preferred Job Skills

Advanced PC proficiency
Knowledge of CPT-4 and ICD-9 coding

Preferred Professional Competencies

Knowledge of managed care, utilization management, and quality management
Working knowledge of McKesson InterQual® criteria

Preferred Leadership Experience and Competencies

Our Commitment

AZ Blue does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.

Thank you for your interest in Blue Cross Blue Shield of Arizona. For more information on our company, see azblue.com. If interested in this position, please apply.

Apply Now

Refine Your Search

medical claims processing jobs in phoenix, az

Initial Clinical Reviewer - Remote - AZ

BH UM Clinical Reviewer- Remote AZ

Health Services Technician (Justice Technician) - Remote AZ

Medical Billing Specialist

Financial Clearance Specialist

Surgical Authorization Specialist- Remote

Insurance Follow Up Representative

RCM / Collections Specialist / Medical Biller - Remote - Pacific Time Zone

Insurance Follow Up/ Medical Biller

Credentialing Coordinator - (Remote in Arizona)

Accounts Receivable Specialist

Insurance Follow-Up Rep

Telehealth Medical Clinic Manager

Sr Medical Biller

Medical Payment Poster

Orthopedic Technician

Sr. Clinical Coder

Center Care Team - Medical Assistant, Bilingual

PATIENT FINANCIAL SERVICE REPRESENTATIVE

In Office Position - Medical Billing Specialist

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