- Phoenix, AZ
- Salary: $40,000 - $50,000 per year
- Full time Contract
Requisition Id: #5080
Position Description:
This position provides administrative support in the Medical Resources Office (MRO) by appropriately managing phone calls, faxes, emails, mail, and other communications. Responsibilities require analysis and application of coding rules, administrative rules, and statutes. The role involves managing the administrative peer review process, supporting the Physician’s and Pharmaceutical Fee Schedule through data analysis and reporting, and participating in agency programs to enhance overall function. Additional tasks include participating in quality improvement exercises, documenting activities, and reviewing and analyzing potential billing conflicts for the Informal Payment Dispute Resolution Program.
This position provides administrative support in the Medical Resources Office (MRO) by appropriately managing phone calls, faxes, emails, mail, and other communications. Responsibilities require analysis and application of coding rules, administrative rules, and statutes. The role involves managing the administrative peer review process, supporting the Physician’s and Pharmaceutical Fee Schedule through data analysis and reporting, and participating in agency programs to enhance overall function. Additional tasks include participating in quality improvement exercises, documenting activities, and reviewing and analyzing potential billing conflicts for the Informal Payment Dispute Resolution Program.
Resources may need to show a Valid Driver's License upon hiring!
Major Responsibilities:
- Provide excellent customer support by managing calls, faxes, emails, mail, and other sources. Analyze issues and provide information and resources as needed. Prepare and send official communication to stakeholders and document interactions.
- Manage the administrative peer review process: review requests, determine next steps, communicate with involved parties, verify information, forward requests to the contractor, and distribute review results.
- Support the Program Manager with annual fee schedule updates by analyzing data, preparing reports on healthcare utilization, and compiling documentation to support proposed changes.
- Participate in division and agency meetings and activities, representing the division as needed.
- Provide administrative support for the division by ordering supplies, processing invoices, and ensuring appropriate resource utilization.
- Perform other duties as assigned related to the position.
Skills:
- Customer service and stakeholder management.
- Strong written and verbal communication skills.
- Analyzing complex issues and providing correct responses.
- Operating a personal computer and various communication tools/software, including Microsoft Office and Google Workspace.
- Managing workload with minimal direction and attention to detail.
Required Skills:
- Utilization review procedures and Current Procedural Terminology (CPT) coding.
- Medical terminology and medical document preparation.
- Medical information maintenance and privacy laws.
- Workers' Compensation laws and rules.
- ICD-10 usage and interpretation.
Preferred Skills:
- Experience in medical billing conflict analysis and informal dispute resolution.
- Data analysis and reporting skills.
Knowledge Areas (KSAs):
- Knowledge of utilization review procedures, CPT coding, and medical terminology.
- Knowledge of Workers' Compensation laws, rules, and ICD-10 coding.
- Understanding of medical document preparation and privacy regulations.
- Familiarity with basic data analysis practices and modern office management.
Abilities:
- Analyze complex issues and provide accurate guidance.
- Interpret laws and rules effectively.
- Communicate professionally with healthcare providers, attorneys, payers, and injured workers.
- Manage multiple tasks with minimal supervision.
- Research information and provide clear summaries.
- Maintain strong attention to detail and organizational skills.
Licenses / Certifications:
- Must possess a valid Arizona Driver's License.
- In-state and out-of-state travel is required.
- Employees who drive on state business must maintain acceptable driving records, complete required driver training, and maintain valid insurance and registration.