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Medicaid Insurance Claims Specialist

2 months ago

Decatur, Georgia, United States Medix Full time
Job Summary

We are seeking a detail-oriented and tech-savvy Medicaid/Medicaid Advantage Follow-Up Specialist to join our team at Medix. In this role, you will be responsible for managing high-volume Medicaid claims, with a focus on follow-up and correction of claims directly through payer portals.

Key Responsibilities
  • Handle 0-90 day follow-up on Medicaid/Medicaid Advantage claims, including both high and low-dollar accounts.
  • Manage and process in-patient and out-patient claims, ensuring all corrections are completed accurately on payer portals.
  • Work closely with various Medicaid HMOs, including Coordinated Care and Molina.
  • Address and remove holds on claims to facilitate timely payment processing.
  • Maintain productivity standards, managing an average of 45 accounts per day.
  • Perform data entry tasks with high attention to detail, ensuring accuracy and compliance with Medicaid regulations.
Requirements
  • Must-Have:
    • Experience with Medicaid Advantage and traditional Medicaid follow-up.
    • Strong attention to detail and proficiency in data entry.
    • Basic computer skills and ability to navigate various payer portals.
    • Experience with both in-patient and out-patient claims processing.
    • Ability to manage high-volume claims efficiently.
  • Nice to Have:
    • Experience with Washington State traditional Medicaid.
    • Proficiency in Cerner (strongly preferred).
    • Familiarity with Medicaid programs in other states
About Medix

At Medix, we are dedicated to providing workforce solutions to clients throughout multiple industries. We have been named among the Best and Brightest Companies to Work For in the Nation for two consecutive years. Medix has also been ranked as one of the fastest growing companies by Inc. Magazine.

Our commitment to our core purpose of positively impacting 20,000 lives affects not only the way we interact with our clients and talent, but also with our co-workers. We strive to create a work environment that is collaborative, inclusive, and supportive of our employees' growth and development.