Job Purpose: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

What You Will Do:

Charge Entry & Claim Preparation

• 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.

Claim Submission & Edit Resolution

• 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.

Documentation & Collaboration

• 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.

Additional Responsibilities

• Meet established productivity and quality standards.
• Participate in training, cross-training, and continuous process improvement initiatives.
• Perform other related duties as assigned.

What We Need From You:

Education

• High School Diploma or GED required.
• 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.

Experience

• 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.

Skills & Knowledge

• 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

What Success Looks Like

Our Billing Representatives are committed to accuracy, quality, and continuous improvement. Success in this role includes:

• Achieving a 95% or higher clean claim first-pass acceptance rate.
• Maintaining 95% or higher claim accuracy during quality audits.
• Meeting established daily productivity goals.
• Preventing avoidable timely filing write-offs.
• Contributing to process improvements that enhance team efficiency and claim quality.

Your Work Schedule:

• Monday to Friday, 8 AM - 4:30 PM (Flexible)
• Location: Denova Collaborative Health LLC - DHQ (Hybrid Work Model after 90 days)

Perks of Being Part of Denova:

• Comprehensive low-cost medical, dental, and vision insurance.
• Generous retirement plan with a 3.5% company match.
• Secure your future with both long and short-term disability options
• Enjoy holiday pay, PTO, and life insurance benefits.
• We offer an employee wellness program and fantastic discounts for all Denova team members.
• And there's so much more waiting for you!

Our Revenue Cycle Mission Our Revenue Cycle team removes friction from the financial side of healthcare so our clinicians can focus on care and our patients can focus on healing.

We succeed when claims go out clean the first time, payments are posted quickly and accurately, denials are prevented, patients understand their responsibility, and team members feel supported. At Denova, we believe: people first, process second, technology third.

Denova Collaborative Health LLCis an integrated primary care and behavioral health practice based in the Greater Phoenix metropolitan area. Our comprehensivevirtual care servicesare available for residents throughout the entire state of Arizona.

We provide a “whole person” approach to health and promote collaboration among our team of primary care providers and specialists. Our unique service integration of primary care, behavioral health, addictionmedicine, and wellness enables our team to provide better health outcomes.