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Senior Medicaid Revenue Cycle Analyst
2 months ago
Position Overview:
The role requires a dedicated professional to manage Medicaid collections effectively. All necessary tools and training will be provided to ensure success in this position.
Work Schedule: 8-hour shifts during regular business hours, Monday to Friday.
Required Skills and Qualifications:
- Strong proficiency in Microsoft Office Suite, particularly Excel, Word, and Outlook.
- Demonstrated experience with Medicaid and Medicare payers.
- Preferred experience in healthcare revenue cycle management, medical billing, and collections (3-5 years).
Key Responsibilities:
- Analyze trends, follow up, and conduct root cause analysis on unpaid and underpaid Medicaid and managed care insurance claims.
- Investigate, appeal, and resolve claim rejections, underpayments, and denials according to established policies and procedures.
- Address issues related to patient coordination of benefits (COB), demographic discrepancies, and Medicare/Medicaid eligibility.
- Identify and correct billing discrepancies based on updates in Medicaid provider manuals and bulletins.
- Handle patient benefit-related denials, including verifying plan requirements and assessing financial risks.
- Utilize various payer systems, provider portals, and internal applications to ensure prompt and accurate claim resolution.
- Build and maintain strategic relationships with internal and external stakeholders, including billing and coding teams, registration departments, and payers.
- Exhibit exceptional organizational, written, and verbal communication skills to document research and actions taken on claims.
- Ensure confidentiality of all company and patient information in compliance with HIPAA regulations.
Education Requirements:
- High school diploma or equivalent is required.
- Associate or bachelor's degree is preferred.
Additional Information:
- Only candidates authorized to work in the designated country will be considered.
- All position start dates and durations are estimates and may vary based on business needs.
Benefits:
For details on employment benefits associated with this position, please refer to the company's benefits page.
Equal Opportunity Employment:
Rose International is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other characteristic protected by law.
If assistance is needed during the application or hiring process due to a disability or other reasons, please contact the HR Department.
