We are a leading provider of revenue cycle solutions catering to hospitals and physicians across the United States. Our commitment lies in delivering exceptional AR support for Out-of-State Medicaid accounts.
Position Overview:
As a Medicaid Eligibility Specialist, you'll play a pivotal role in ensuring seamless Medicaid eligibility, authorization, billing, and follow-up procedures. Your dedication will directly contribute to our mission of providing top-notch revenue cycle solutions.
Essential Duties and Responsibilities:
Accurately identify Medicaid eligibility, authorization, enrollment, and documentation requirements for hospital and physician accounts, with full support and training provided.
Initiate authorization requests to Medicaid payers and diligently follow up to ensure timely resolution.
Perform meticulous manual data entry of patient accounts and claim forms.
Obtain necessary bills, medical records, or documentation from medical providers promptly.
Review and meticulously edit claims to adhere to state and federal guidelines.
Ensure timely and accurate submission of claims to Medicaid payers.
Conduct proactive follow-up on unresolved claims, facilitating timely payments.
Research denials and underpayments, preparing and submitting appeal letters or disputes in accordance with state guidelines.
Collaborate with the cash posting team by submitting payment details.
Work in strict compliance with state and federal regulations, including HIPAA and FDCPA.
Maintain clear, concise, and accurate account notations.
Monitor account statuses and effectively communicate with management, clients, and other stakeholders.
Provide prompt responses to client inquiries within 24 hours.
Perform any other duties as assigned.
Qualifications and Requirements:
To excel in this role, you should possess:
High School Diploma or GED.
Working knowledge of ICD9, CPT codes, HIPAA, HCPCS, and Medicaid (preferred).
1-2 years of related experience in the healthcare industry or a related field.
Exceptional verbal and written communication skills.
Strong organizational abilities.
Proficiency in multitasking.
Critical thinking skills and keen attention to detail.
Computer proficiency, including data entry, word processing, MS Office applications, and navigating web-based platforms.
For remote and hybrid positions, a home internet connection meeting specified upload and download speed criteria is required.
Benefits:
We prioritize the well-being of our employees and their families. Here's a glimpse of the benefits we offer:
Comprehensive Medical, Dental & Vision Insurance
401K with generous match
15 days of Paid Time Off (PTO)
7 paid Holidays
2 Floating holidays
1 Elevate Day (floating holiday)
Pet Insurance
Employee referral bonus program
Emphasis on Teamwork and Fun
Opportunities for Career Growth
Please Note:
Salary for this position will be determined based on various factors, including experience, education, and location. This job description is subject to change to meet evolving organizational needs.
We look forward to welcoming a dedicated professional to our team who shares our commitment to excellence and integrity in healthcare revenue cycle management.
Employment Type: Full-Time
Salary: $ 17.00 21.00 Per Hour
