Billing Representative

Denova Collaborative Health•Phoenix, AZ

3d•Hybrid

About The Position

Join Denova Collaborative Health as a Billing Representative, where your attention to detail and commitment to accuracy directly support our mission of delivering integrated, whole-person healthcare. In this role, you will help produce clean, compliant claims the first time by ensuring accurate charge entry, resolving claim edits, and submitting claims within payer guidelines. Your work will play a critical role in improving reimbursement, reducing denials, and strengthening our revenue cycle operations. This position is non-exempt and will report to the RCM System & Solution Mgr

Requirements

High School Diploma or GED required.
One to three years of healthcare revenue cycle, medical billing, or claims processing experience preferred.
Experience with Electronic Health Records (EHR) and practice management systems, preferably AMD.
Knowledge of medical billing processes, insurance claims, CPT, HCPCS, ICD-10 coding, and payer guidelines.
Strong attention to detail with the ability to identify and resolve claim discrepancies.
Excellent organizational, communication, and problem-solving skills.
Ability to work independently while collaborating effectively within a team.
Commitment to maintaining HIPAA compliance and protecting patient information.
Must be located in Arizona

Nice To Haves

Associate's or Bachelor's degree in Healthcare Administration, Business, or a related field preferred.
HFMA CRCR certification or other relevant healthcare revenue cycle certification is a plus.

Responsibilities

Enter and validate charges accurately in the billing system while meeting daily productivity expectations.
Verify CPT, HCPCS, ICD-10 codes, units, dates of service, and provider information before claim submission.
Apply appropriate modifiers and confirm place of service and rendering provider information.
Attach required documentation, referrals, and authorizations prior to claim submission.
Submit professional and behavioral health claims to the appropriate payer within timely filing requirements.
Resolve claim edits and clearinghouse scrubber errors before submission.
Correct front-end issues including demographic, eligibility, and registration discrepancies.
Rebill and resubmit corrected claims for standard rejection reasons.
Document all claim activity in AMD using standardized documentation practices.
Escalate complex payer edits or claim issues after appropriate troubleshooting.
Identify recurring claim edits and communicate trends to leadership.
Collaborate with internal departments to ensure accurate and timely claim processing.
Meet established productivity and quality standards.
Participate in training, cross-training, and continuous process improvement initiatives.
Perform other related duties as assigned.