Medicaid Specialist
2 weeks ago
We are looking to add top talent to our Baptist Hospitals of Southeast Texas team.
Join us in performing Sacred Work
Competitive benefits are offered including:
Matched Retirement Plan
Paid Time Off
Comprehensive Benefit Plan - Medical, Dental, Vision and Much More
Bonus Potential
Summary/Objective
The Medicaid Specialist ensures that all Medicaid claims are billed timely and accurately. Works remittance and rejection reports daily to identify issues. Processes appeals when applicable.
Essential Job Duties
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
* Reviews and corrects all Medicaid final and interim billed claims daily for accurate billing within guidelines and notify management of any issues for review and resolution.
* Works remittance reports from Medicaid to identify errors, denials, recoupments, incorrect payments, etc. and obtains the necessary information to rebill/appeal.
* Works daily track and aging reports to ensure all outstanding claims are resolved according to federal guidelines with PHI.
* Monitors Inpatient accounts for authorization prior to billing as required.
* Ensures the accuracy of accounts as reviewed and when identified, submits corrections/adjustments to the patient account.
* Ensures denial info is entered into the appropriate system to facilitate collection of accounts.
Required Education and Experience
High School diploma or equivalent
1 - 3 years' experience
Required License/Certifications
N/A
