Two Chicks With A Side Hustle

Overview of Position

The Billing Specialist is responsible for a variety of tasks including Medicaid claims submission and denial management of all claims for assigned clients. The Billing Specialist will primarily be responsible for hospital claims but may also work associated professional claims. Assigned work may include state specific Medicaid or Out of State Medicaid claims. This position is responsible for ensuring all claims are processed in a timely manner according to state Medicaid guidelines and to ensure maximum reimbursement.

What will be my duties and responsibilities in this job?

  • Ensure billing inventory for all assigned clients is managed to the process activity metrics and financial goals as set by the company.
  • Responsible for ensuring the timely and accurate billing of all accounts for assigned clients.
  • Responsible for entering Medicaid eligibility information into the client system.
  • Responsible for denial management of all assigned claims.
  • Responsible for analyzing all remits to ensure accurate payment has been received.
  • Ensure proper and timely notes are document in both Change Healthcare system and client system.
  • Keeps Supervisor aware of any issues that may be impacting claims resolution.
  • Helps Supervisor to build and maintain strong, long-lasting customer relationships.
  • Assists co-workers with questions.
  • Responsible for provider enrollment.
  • Assist manager in preparing monthly status reports for clients.
  • Participates with Manager in monthly client meetings with clients to discuss billed inventory with a focus on performance reporting and issue resolution.
  • Helps Manager to build and maintain strong, long-lasting customer relationships. May be required to work on site with client billing team as needed.
  • Assist with high severity requests or issue escalations as needed

What are the requirements needed for this position?

  • Minimum 3 years of experience in billing and denial management. Preferably with Medicaid and in a hospital setting.
  • Minimum 2 years of experience in Medicaid/Government AR follow-up
  • Minimum high school diploma or GED, some college preferred
  • Thorough knowledge of Medicaid HOSPITAL billing guidelines; experienced with Medicaid billing in states other than Georgia also desire

What other skills/experience would be helpful to have?

  • General knowledge of Microsoft Office
  • Advanced Excel and PowerPoint skills
  • Strong communication skills, both written and verbal
  • Excellent customer service skills
  • Strong follow-up and organizational skills
  • Ability to work collaboratively within a team and with limited supervision
  • Ability to think strategically
  • Ability to follow HIPPA policies and confidentiality processes

What are the working conditions and physical requirements of this job?

  • Use of phone and computer
  • Sitting for long periods of time
  • Work from home – must have solid internet connection and quiet space