Monday through Friday 8am-5pm (this position has some flex potential to where you can work 4-10s, 5-8s or even 4.5 days, as long as you make your own 40 hour work week schedule)
Responsibilities:
• Submit authorization requests to Medicaid payers and perform appropriate follow up to ensure authorization requests are resolved in a timely manner
• Obtain bills, medical records or other necessary documentation from medical providers in a timely manner
• Review and edit claims to ensure they meet state and federal guidelines
• Submit claims timely and accurately to Medicaid payers
• Perform aggressive follow-up on unresolved claims
• Facilitate timely payment from Medicaid payers
• Research denials and/or underpayments and formulate appeal letters and/or disputes to Medicaid plans in accordance with state guidelines
• Submit payment details to the cash posting team
• Work in compliance with state and federal guidelines, including HIPAA and FDCPA
• Monitor the status of accounts and communicate effectively with management, clients and other parties regarding the status of the accounts
Qualifications
• Two (2) or more years of health insurance claims experience, such as claims education, claims processing
• Knowledge of MMIS Medicaid Portal and Microsoft Office applications