• 517541

• PHOENIX
• REMOTE OPTIONS

• AHCCCS

• Full-time

AHCCCS

Arizona Health Care Cost Containment System
Accountability, Community, Innovation, Leadership, Passion, Quality, Respect, Courage, Teamwork

The Arizona Health Care Cost Containment System (AHCCCS), Arizona’s Medicaid agency, is driven by its mission to deliver comprehensive, cost-effective health care to Arizonans in need. AHCCCS is a nationally acclaimed model among Medicaid programs and a recipient of multiple awards for excellence in workplace effectiveness and flexibility.

AHCCCS employees are passionate about their work, committed to high performance, and dedicated to serving the citizens of Arizona. Among government agencies, AHCCCS is recognized for high employee engagement and satisfaction, supportive leadership, and flexible work environments, including remote work opportunities. With career paths for seasoned professionals in a variety of fields, entry-level positions, and internship opportunities, AHCCCS offers meaningful career opportunities in a competitive industry.

Come join our dynamic and dedicated team.

Address:  801 East Jefferson Street, Phoenix, Arizona 85034

Open to filled: 1st resume review will be on 05/19/2023

Salary:  $42,460.08

Grade: 19

Must reside in the State of Arizona.

This position is eligible for part-time/full-time remote work (including virtual office arrangement). 

This position is one of three staff who administers and coordinates all areas of the AHCCCS Reinsurance Program as related to the contractual agreement with the AHCCCS Managed Care Organizations (MCOs) and Program Contractors, and reimbursement for transplant related services for nine Indian Health Services (IHS) Fee for Service plans. This staff member will determine compliance with contractual agreements for Reinsurance consideration for acute, catastrophic and transplants.

Major duties and responsibilities include but are not limited to:

• Audit PMMIS encounters and reinsurance payments to ensure that they are appropriately encountered by the
  contractor and processed. Use knowledge of coding and claims as well as AHCCCS Reinsurance processing
  rules to assist the Contractor when necessary in identifying impediments to processing though PMMIS.
• Audit critical monthly reports to ensure contractors program compliance and make necessary recommendations
  when needed.
• Audit, Research and Adjudicate Reinsurance claims based on interpretation of AHCCCS Policies, Procedures
  and Contracts and laws.

Knowledge of an/or ability to learn:

• AHCCCS Reinsurance Policy and Procedures
• AHCCCS Contracts for MCOs, Program Contractors and Fee for Service
• Knowledge of principles and practices of auditing and accounting
• Demonstrated experience with claims, encounters or ICD-9 or 10 coding 
• Policies and Procedures established for the work system

Skill:

• Techniques of complex research
• Demonstrated skills in auditing
• Strong customer service skills
• Excellent interpersonal, written, oral communication
• Demonstrated experience working in the PMMIS system

Ability: 

• Demonstrated ability to balance, prioritize and organize multiple tasks, work collaboratively in teams
• Work under limited supervision 
• Prioritize projects

Minimum: 

• Experience in auditing work, principles, standards and technique.

Preferred: 

• Bachelor's Degree in accounting or closely related field.

• Successfully complete the Electronic Employment Eligibility Verification Program (E-Verify), applicable to all newly hired State employees. 
• Successfully pass fingerprint background check, prior employment verifications and reference checks; employment is contingent upon completion of the above-mentioned process and the agency’s ability to reasonably accommodate any restrictions. 
• Travel may be required for State business. Employees who drive on state business must complete any required driver training (see Arizona Administrative Code R2-10-207.12.) AND have an acceptable driving record for the last 39 months including no DUI, suspension or revocations and less than 8 points on your license. If an Out of State Driver License was held within the last 39 months, a copy of your MVR (Motor Vehicle Record) is required prior to driving for State Business. Employees may be required to use their own transportation as well as maintaining valid motor vehicle insurance and current Arizona vehicle registration; however, mileage will be reimbursed.

Among the many benefits of a career with the State of Arizona, there are: 

• 10 paid holidays per year
• Paid Vacation and Sick time off (13 and 12 days per year respectively) - start earning it your 1st day (prorated for part-time employees) 
• A top-ranked retirement program with lifetime pension benefits 
• A robust and affordable insurance plan, including medical, dental, life, and disability insurance 
• Participation eligibility in the Public Service Loan Forgiveness Program (must meet qualifications) 
• RideShare and Public Transit Subsidy 
• A variety of learning and career development opportunities

For a complete list of benefits provided by The State of Arizona, please visit our benefits page

Lifetime Pension Benefit Program 

• Administered through the Arizona State Retirement System (ASRS) 
• Defined benefit plan that provides for life-long income upon retirement. 
• Required participation for Long-Term Disability (LTD) and ASRS Retirement plan. 
• Pre-taxed payroll contributions begin after a 27-week waiting period (prior contributions may waive the waiting period). 

Deferred Retirement Compensation Program 

• Voluntary participation. 
• Program administered through Nationwide. 
• Tax-deferred retirement investments through payroll deductions.

Persons with a disability may request a reasonable accommodation such as a sign language interpreter or an alternative format by emailing careers@azahcccs.gov.
Requests should be made as early as possible to allow time to arrange the accommodation. Arizona State Government is an AA/EOE/ADA Reasonable Accommodation Employer.