Medical Claims Specialist

5 days ago


Houston, Texas, United States St. Josephs Medical Center Full time
Job Summary

We are seeking a skilled Medicaid Billing Specialist to join our team at St. Josephs Medical Center. As a key member of our revenue cycle department, you will play a crucial role in ensuring the accurate and timely submission of Medicaid claims.

Responsibilities:
  • Review claims for accuracy and completeness before submission
  • Validate and correct claim edits on the UB04 form
  • Verify pharmacy quantities on claims and resolve discrepancies
  • Ensure accurate billing of procedures by validating claims against coding abstracts
  • Split inpatient claims according to carrier guidelines
  • Submit claims with relevant remarks and attachments
  • Run insurance eligibility checks and resolve claim issues as needed
  • Pull supporting documents for audits and resolve Medicaid credit balances


Requirements

To succeed in this role, you should have a minimum of 2 years of experience in Medicaid billing, preferably in an acute care facility. You must possess a working knowledge of CPT and ICD10 codes, as well as Federal, State, and Commercial billing guidelines.

Compensation

The estimated annual salary for this position is approximately $65,000-$80,000, depending on experience. Our hospital offers a competitive benefits package, including medical, dental, and vision coverage, as well as a 401(k) retirement plan.

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