Medical Claims Specialist with Behavioral Innovations
7 days ago
The Medical Claims Specialist role at Behavioral Innovations is a critical position that ensures the timely and accurate submission of medical claims to Medicaid carriers. This individual will be responsible for reviewing and assessing denials or returned claims, communicating effectively with Medicaid and MCOs, and ensuring compliance with regulatory mandates.
Duties & Responsibilities:
- Initiate claims adjustments and resubmissions to Medicaid and MCOs
- Evaluate payments/denials received for correctness and ensure proper application
- Maintain contact with other departments to obtain patient or insurance information needed for claim payment
- File and handle confidential documentation and patient health information (PHI), adhering to HIPAA guidelines
- Analyze and evaluate Medicaid claim payments using company systems and tools
- Conduct timely and thorough telephone follow-up with Medicaid to ensure claims have been received and facilitate prompt reimbursement
Requirements:
We are seeking an experienced professional with 3-5 years of healthcare industry experience, specifically in medical billing and collections. An Associate's degree is preferred, but five years of experience can be substituted. Strong communication and interpersonal skills are essential for success in this role.
Benefits:
Behavioral Innovations offers a competitive salary of $62,000 - $72,000 per year, depending on experience. Additional benefits include daily pay, wellbeing program, OVIA Health app, employee assistance program, tuition reimbursement, supportive team structure, career advancement opportunities, and comprehensive insurance policies.
Salary Range: $62,000 - $72,000 per year
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