Member Services Specialist - Sierra Vista, AZ; Sierra Vista Clinic

Job Description

Sierra Vista, AZ, USA

Posted Friday, January 30, 2026 at 9:00 AM | Expires Wednesday, April 1, 2026 at 9:59 AM

Looking to build a lasting career? Join a team that is inclusive and embraces all individuals. Intermountain Centers is one of the largest statewide behavioral health and integrated care organizations in Arizona.

• Exceptional health, dental, and disability benefits
• Career and compensation advancement programs
• Student loan forgiveness programs
• 401(k) company match
• Holiday, PTO, and employer paid life insurance
• Clinical licensure supervision and reimbursement
• Evidence-based treatment approaches, training, and supervision

Intermountain Centers and its statewide affiliates are currently recruiting career-minded individuals interested in opportunities within the largest adult and child service continuum in Arizona.

Member Services Specialist is primarily responsible for ensuring all members and customers have a positive experience throughout the provision of services by addressing their needs, questions, and concerns. The Specialist also validates payer information prior to and during services provision.

• Guide members through the enrollment process.
• Verify eligibility prior to enrollment with an understanding of acceptable and/or restrictions with insurance for each program.
• Within 24 hours of a new member chart set-up by Medical Receptionist, validate insurance eligibility with the source of truth.
• For new walk-in members, set up an initial EHR chart and validate insurance eligibility with the source of truth.
• On a weekly basis, validate member eligibility and benefit plan for members coming in for future appointments using the source of truth.
• Explain coverage details, including co-pays, deductibles, and out-of-pocket maximums to members.
• Complete a thorough verification of benefits (plan, co-pays/HSA/HRA, co-insurance, prior authorization requirements).
• Initiate request for initial prior authorization and pass to Quality Management for maintenance.

• Reconcile member roster with health plan records two times per week.
• Ensure and verify member eligibility throughout service provision.
• Update member record as needed.
• Coordinate with the claims/billing department to ensure accurate processing of claims.
• Review and correct the unbilled services report twice per week.
• Correct all claims/billing discrepancies within three business days of notification.
• Ensure all critical elements are end dated in the EHR; discharge within 24 hours of notification.
• Report health plan and claim discrepancies to designated department staff; report eligibility and payer loss issues.

• Respond to all referrals and request additional information when needed.
• Work with all programs to respond timely to referring programs/coordinators; upload required documents as directed.
• Coordinate scheduling of services with program staff.

• Provide back-up support when the Medical Receptionist is on PTO/PSL or during supervisor meetings.
• Schedule appointments and manage calendars for behavioral health providers.
• Maintain accurate and up-to-date member records in electronic health systems.
• Handle correspondence, including emails and phone calls, in a professional manner.

• Address member concerns, escalating as needed to SME.
• Perform other duties as assigned or necessary related to the general nature of the position.
• Participate in monthly supervision with State Member Services Manager.
• Participate in Member Services training as directed.
• Integrate with Program Staff, participating in Program Team meetings and events; comply with office and attendance policies.
• Answer the multiline phone system.
• Maintain an approved schedule and acceptable level of attendance.

• Minimum Education:
  
  High School Diploma or equivalent.
• Minimum Experience:
  
  Two years of customer service experience in the healthcare industry (medical or behavioral health). Experience with Electronic Health Records preferred.
• Extensive knowledge of eligibility and referral processes.

• Minimum age: 21 years.
• Valid AZ DPS Level I fingerprint clearance card; must maintain valid card throughout employment.
• CPR, First Aid, AED certification if required; must maintain throughout employment.

Questions about this position? Contact

Intermountain Centers is an equal opportunity employer. Intermountain Centers does not discriminate based on age, ethnicity, race, sex, gender, religion, national origin, creed, tribal affiliation, ancestry, gender identity, sexual orientation, marital status, genetic information, veteran status, socio-economic status, claims experience, medical history, physical or intellectual disability, ability to pay, source of payment, mental illness, and/or cultural and linguistic needs, as well as any other class protected by law.