Job Summary: Claims Clinical Documentation Reviewer reports to the Prepayment Program Manager and is responsible for reviewing clinical and/or supportive documentation, submitted by provider organizations, in support of billed medical, behavioral health, NEMT and other related Medicaid services by applying knowledge of healthcare State, Federal, and AHCCCS laws, policies, and practices. Monitor over and under service utilization, conduct prepayment claims reviews, provide oversight and technical assistance, gather, plan, organize and evaluate information from multiple sources, including utilization data, case file reviews and audits.