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Medicaid Specialist
3 months ago
Overview:
**_ Voted by Newsweek in 2024 as one of America's Greatest Workplaces for Diversity_**
**Early Access to Paycheck with Earned Wage Access is available for Hourly Associates (outside of CA)**
**Make Lives Better Including Your Own**.
If you want to work in an environment where you can become your best possible self, join us You’ll earn more than a paycheck; you can find opportunities to grow your career through professional development, as well as ongoing programs catered to your overall health and wellness.
Full suite of health insurance, life insurance and retirement plans are available and vary by employment status. Additional benefits offered include, but are not limited to:
- Tuition Reimbursement
- Pet Insurance
- Adoption Reimbursement Benefits
- Variety of Associate Discounts
Veterans, transitioning active duty military personnel, and military spouses are encouraged to apply.
Please note, Brookdale is committed to complying with all applicable laws and regulations regarding mandatory COVID-19 vaccination.
**Responsibilities**:
Responsible for using established guidelines, tracking resident data, processing charges and paperwork, reconciling resident accounts, submitting billing and researching denials and payments for Medicaid State payers including Managed Care Organizations (MCO’s) for multiple states. Responds to written and verbal communications from residents, field personnel, financial/medical caseworkers and peers.
- Submit monthly billing for multiple states through clearinghouse or web portals.
- Review payments from state/MCO for accuracy.
- Maintain authorizations for services and ensure accurate charges are reflected on accounts.
- Perform accurate account research and necessary adjustments based on situation and state/MCO regulations.
- Correspond with payers, communities, and/or caseworkers to correct or modify payments received.
- Identify potential issues through review of daily, weekly, and monthly generated reports.
- Research and assist in processing of state/MCO refunds.
- Other duties as assigned based upon business need by manager/supervisor
- This job description represents an overview of the responsibilities for the above referenced position. It is not intended to represent a comprehensive list of responsibilities. An associate should perform all duties as assigned by his/her supervisor._
Qualifications:
**Education and Experience**
High school diploma or general education degree (GED) required. Associate’s or Bachelor’s Degree preferred. Minimum three years experience with Assisted Living Medicaid billing including state Medicaid programs and MCO programs with an emphasis on account resolution.
**Certifications, Licenses, and Other Special Requirements**
None
**Management/Decision Making**
Makes standard and routine decisions based on detailed guidelines with little independent judgment. Problems are generally solved with clear, detailed guidelines or by reporting them to a supervisor.
**Knowledge and Skills**
Has a basic level of a skill and can follow written or verbal instructions. Has basic technical skills to complete a few repetitive and well-defined duties. Has a basic knowledge of the organization in order to answer basic questions. Possesses excellent verbal and written communication skills. Proficient in Microsoft Office (Excel, Word, Outlook, etc.).
**Physical Demands and Working Conditions**
- Standing
- Walking
- Sitting
- Use hands and fingers to handle or feel
- Reach with hands and arms
- Stoop, kneel, crouch crawl
- Talk or hear
- Ability to lift: up to 25 pounds
- Vision
- Requires interaction with co-workers, residents or vendors
Brookdale is an equal opportunity employer and a drug-free workplace.
Salary Range Information: $16.60 - $20.75 / hour
