The Clinical Trainer and Auditor is responsible for developing and delivering clinical education programs while ensuring compliance with NCQA, CMS, and AHCCCS standards. They also perform audits of clinical documentation and staff performance to maintain quality and regulatory standards.
The analyst is responsible for researching and reviewing claims to recover eligible stop-loss reimbursements for Medicaid and Medicare lines of business. They also manage transplant and catastrophic reinsurance cases while ensuring compliance with AHCCCS guidelines and reporting requirements.
The position involves updating and maintaining accounting records while reconciling financial accounts and preparing reports. The role also requires corresponding with customers via telephone, in writing, or in person to resolve inquiries.
The role involves building partnerships with individuals and families to promote recovery and wellness while identifying barriers to service delivery. The liaison will also collaborate with providers and stakeholders to ensure compliance with policy requirements and advocate for person-centered care environments.
