Data Validation Manager

Arizona's Children Association is looking for a Data Validation Manager to join the team! The Data Validation Manager is responsible for oversight of internal billing and medical records audits, and the provision of training and technical assistance of behavioral health coding and billing activities. The Data Validation Manager is also responsible for the identification, development, implementation and ongoing administration of the agency's fraud, waste and abuse detection software system. This position works closely with the Compliance, Performance & Quality Improvement Coordinators for Behavioral Health, Behavioral Health Program Directors, and the Claims and IT Departments. The Date Validation Manager may also supervise a Data Validation Specialist.

Who We Are

Founded in 1912, Arizona's Children Association is one of the oldest and largest statewide comprehensive child welfare and behavioral health not-for-profit agencies in Arizona. Located in all 15 Arizona counties, we provide a variety of programs and services to meet the needs of more than 40,000 children, youth and families each year. When working with AzCA, you'll be surrounded by highly talented and dedicated individuals who are committed to our mission of protecting children, empowering youth, and strengthening families.

Why You'll Love Working for Us

At Arizona's Children Association, our employees are our most valuable asset; and as such we offer a wide range of benefits to aid your health and wellness including:

  • Eligibility for Medical, Dental, and Vision plans on the first of the month following 30 days of employment
  • Generous paid time off, paid sick leave, and 8 paid holidays
  • 403B Retirement Savings Plan
  • Employee Assistance Program
  • Health Savings Account (HSA) and Flexible Savings Account (FSA)

2023 Benefits Guide

Find your passion. Join our Team!

Essential Job Functions:

- Reviews billing and coding data and documentation in the electronic health record to determine accuracy, quality and timeliness.

- Coordinates preparation for and participation in required Data Validation audits, performance and quality improvement activities,

- Researches resolution of denied and/or rejected claims, and implementation of new and updated billing and coding practices and requirements.

- Completes, reviews and approves reports of internal data validation audits to share with program directors, CPQI staff, and other administration officials.

- Evaluates medical records and progress notes to ensure completeness, accuracy and compliant coding.

- Runs internal reports and determines omissions, correctness errors, and measures timeliness of encounter submissions.

- Validates encounter acceptance within the agency claims system.

- Provides verbal and written technical assistance, training and education on medical coding to staff to improve accuracy of chart coding.

- Investigates applicable critical incidents, internal complaints, formal grievances and prepares reports of findings.

- Verifies CPT codes and follows internal procedures for submitting questions to clients before processing.

- Adheres to all federal and agency-issued coding compliance laws, policies, and procedures.

- Participates in coding review process to provide feedback.

- Assists with the transition and implementation of any new coding, regulation and/or behavioral health billing policies and procedures, and communicates information and procedures to all relevant staff.

- Monitors and evaluates the overall quality of behavioral health services provided by the agency to ensure compliance with contracts, licensing and regulations.

- Selects, implements and oversees the ongoing administration of the agency's fraud, waste and abuse detection software system; including development of policies, procedures, and any applicable training.

- Performs other duties as assigned, which are consistent with the general responsibilities of the position.

Minimum Education & Experience:

- Bachelor's Degree in social services or related field required; Master's Degree in Social Work, Business, or related field from accredited college or university preferred.

- Minimum of 3 years' experience in data validation or medical coding.

- Or, Equivalent combination of education and experience to be able to perform the essential functions is required.

Minimum Qualifications & Requirements

  • Complete initial intake assessments for clients and families seeking services for the first time, creating an emotionally and physically safe environment.
  • Must be 21 years of age (licensing requirement).
  • Possess a valid Arizona driver's license and be insurable under the agency's automobile policy.
  • Must be able to provide own transportation to and from clients' homes and/or other relevant organizations/agencies
  • Must be able to provide DPS fingerprint clearance.
  • Must be able to meet training and agency compliance requirements for the position.
  • An individual may qualify for this position if the individual is able to "perform safely" the essential functions of the position with or without reasonable accommodations.

At Arizona's Children Association we are passionate about creating an inclusive workplace that not only promotes, but values and celebrates diversity. Our goal is to create an inclusive workplace and culture to better serve our children, families, and community.

Just like the uniqueness of the families we serve, we strive to be diverse in:
race, color, ethnicity, national origin, culture, language, gender, age, sexual orientation/preference, gender identity and expression, disability and/or diagnosis, marital status, religion, status, or any other protected status.

AzCA does not tolerate discrimination or harassment based on any of these characteristics.