Overview
A remote opportunity based in Arizona is available for a Program Administration Authorization and Billing Associate. This role involves serving as a liaison between Operations and Finance departments, focusing on revenue recognition, obtaining authorizations, and performing eligibility checks for individuals receiving community-based services for intellectual and developmental disabilities.
Responsibilities
- Obtain eligibility and initial authorizations for all new admissions and unfunded individuals served.
- Utilize billing systems (Avatar & iServe) to capture service entry, admissions, discharges, and transfers prior to billing.
- Review eligibility and submit requests to update payer information or changes.
- Manage and proactively obtain subsequent authorizations until discharge; submit to the appropriate team for processing.
- Review attendance and meal counts for accuracy before charge entry; maintain supporting documentation.
- Reconcile weekly and monthly service capture for all payers and individuals prior to billing.
- Participate in weekly/monthly accounts receivable calls, providing updates on authorization and eligibility issues.
- Provide information for quarterly reserve processes as needed.
- Ensure compliance with internal controls and audit requirements, maintaining an effective control environment.
- Assist with resolving issues impacting month-end close timing.
- Support onboarding of new hires by providing necessary training.
- Update and modify control designs timely; oversee remediation activities if exceptions occur during testing.
Requirements
- High school diploma or equivalent required; Associate or Bachelor’s degree preferred.
- Experience with Arizona state-specific insurance required.
- Knowledge of autism and behavioral health services.
- Minimum of one year experience in medical administration and/or medical billing.
- Experience with payer online portals and knowledge of EDI 835 formatting preferred.
- Proficiency in Microsoft Word, Excel, and Outlook.
- Detail-oriented with strong multitasking abilities.
- Demonstrated communication, problem-solving, and data entry skills.
- Excellent interpersonal skills with the ability to build rapport.
- Commitment to excellent customer service and support.
Compensation & Benefits
- Hourly pay range: $19-$20.
- Full compensation and benefits package for employees working 30+ hours per week.
- 401(k) plan with company match.
- Paid time off and holiday pay.
- Job security with nationwide career development and advancement opportunities.
Location
- Remote position based in Arizona, USA.
Equal Opportunity Statement
Applicants and employees with disabilities must be able to perform essential job functions with or without reasonable accommodations. The employer is an equal opportunity organization and does not discriminate based on race, color, religion, sex (including pregnancy, sexual orientation, or gender identity), national origin, age, disability, genetic information, veteran status, citizenship, or any other protected characteristic by law.