Midwest Regional Billing Specialist
7 days ago
Job Location
Lenexa, KS
Remote Type
Fully Remote
Salary Range
$23.00 - $25.00
Description
ABOUT THE COMPANY
Acumen, LLC. is one of the nation's leading fiscal agents offering a portfolio of innovative financial management services backed by superior customer service. Our passion is to help people lead independent lives through exceptional participant-directed programs. Acumen is a great place to work. Our employees make a positive difference in our clients lives by what they do. Among many benefits to working here, we offer medical, dental and vision coverage, generous paid time off, and incentive bonuses to those who qualify.
OVERVIEW AND ESSENTIAL JOB FUNCTIONS
The Billing and Aging Support Specialist plays a critical role in ensuring accurate and timely billing processes across the Midwest regions. This position supports the resolution of billing exceptions, Medicaid eligibility issues, EVV aggregation failures, and authorization discrepancies. The specialist will collaborate closely with Billing, AEB (Texas), and Operations teams to proactively identify and resolve issues that impact claim submission and reimbursement.
Kansas Region Support:
- ACS Authorizations (Daily):
- Run and analyze Pending and Missing Authorization Reports.
- Approve authorizations and escalate missing items to MCOs.
- Average 2 hours/day including research and resolution.
- Exceptions Dashboard (Daily):
- Review claims stuck in exceptions (current and past 180 days).
- Add issues to internal tracking spreadsheets.
- Resave claims to correct authorizations as needed.
- Average 2 hours/day.
- Unbillable Claims (Monthly):
- Identify exhausted claims and add to ACS Unbillable Claims spreadsheet.
- Approx. 2 hours/month.
- Medicaid Ineligibility Tracking (Daily):
- Identify and document clients who have lost eligibility.
- Under 1 hour/day.
- FMS Claims (Monthly):
- Run reports by service code to identify clients needing manual FMS claims.
- Build and bill 20-30 claims manually.
- Approx. 4 hours/month.
- EVV Aggregation & Verification (Daily):
- Review "Texas Aggregation Results" and "Verification Report."
- Identify failure reasons and take corrective actions in DCI or via IssueTrak.
- Use TMHP to verify Medicaid eligibility and notify relevant teams of changes.
- TMHP Monitoring (Monthly):
- Maintain and update group eligibility batches.
- Compare TMHP data with DCI and report discrepancies.
- Notify AEB, Billing, and TX Managers of any changes.
- Collaboration & Communication:
- Attend weekly aging meetings to provide updates and receive feedback.
- Coordinate with Payroll, AEB, and Billing teams to resolve outstanding issues.
- Track IssueTrak progress and escalate as needed.
- Perform all other job-related duties as assigned
- ALL Acumen employees will be vigilant to support the positive compliant cybersecurity company posture by familiarizing themselves with all policies, procedures, standards, and guidelines and act accordingly.
MINIMUM QUALIFICATIONS
- Experience in billing, Medicaid, or healthcare operations preferred.
- Strong analytical and problem-solving skills.
- Proficiency with DCI, TMHP, and data reporting tools.
- Excellent communication and collaboration abilities.
- Ability to manage multiple priorities and meet deadlines.
Acumen is an Equal Employment Opportunity (EEO) employer. We embrace diversity in all its form. We provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.
If you require reasonable accommodation for any part of the application process or hiring process, please submit your request through one of the following methods listed below:
(a) Dedicated fax 866-268-8885
(b) Dedicated email hrdept@riseservicesinc.org DISABILITY ACCOMMODATION REQUESTS ONLY
(c) US mail - 4554 E Inverness Ave Mesa, AZ 85206- Attn Human Resources
(d) Dedicated phone 1-866-242-2714 Option 1 (Employment Opportunities) DISABILITY ACCOMMODATION REQUESTS ONLY
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