Medical Claims Specialist

3 weeks ago


Montrose, Colorado, United States Ethan Allen Workforce Solutions Full time

Job Title: Medical Claims Specialist

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About the Role:

We are seeking a highly experienced Medical Claims Specialist to join our team at Ethan Allen Workforce Solutions in Montrose, NY. As a Medical Claims Specialist, you will play a vital role in assisting potential residents and managing critical financial operations.

Responsibilities:

  • Conduct comprehensive financial interviews to determine pay sources for prospective residents.
  • Prepare, submit, and follow up on Medicaid applications to ensure timely processing.
  • Oversee annual recertification submissions to maintain accurate records.
  • Collaborate with various departments and external agencies, including the NYS Department of Social Services.
  • Troubleshoot referral cases and resolve issues efficiently.
  • Develop and present monthly reports to stakeholders.

Requirements:

  • 5-10 years of relevant experience in medical claims or long-term care.
  • Proven expertise in Medicaid and Medicare processes.
  • Experience managing company revenue and maintaining accurate financial records.
  • Strong communication, organizational, and problem-solving skills.

Why Choose Us?

This is an exciting opportunity to leverage your expertise in a meaningful role that directly impacts individuals and their families. Enjoy a flexible, supportive work environment with a competitive hourly rate of $30-$33.



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