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Job Details

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Louisville, KY

Salary: $16.00 to $18.00
Date Posted: May 22, 2017
Job Type: Direct Hire
Job ID: 266159

Job Description

What makes this position different than all the other Claims Specialist or Claims Analyst? The big difference is an opportunity our client is experiencing considerable growth, and this also means opportunities for those who join the team. The Medicaid Claims Specialist is a position our client has retained our services to identify and help hire a full-time Medicaid Claims Specialist who can execute the required work and fit into the entrepreneurial growth environment.

You would ultimately be responsible for the submission of clean and timely patient claims to Medicaid and Managed Care Medicaid insurance companies.

What will you be doing?

  • Review assigned reports and correct claims that are on hold or rejected. Note accounts as appropriate
  • Review system reports to identify delinquent accounts
  • Performs insurance verification to determine coverage and benefit eligibility of patient
  • Follow up with insurance to identify reason for non-payment. Take the appropriate and necessary action to have the claim paid
  • Maintain thorough and detailed knowledge of Medicaid fee schedules and reimbursement rules
  • Demonstrate thorough knowledge of UB and 1500 electronic and hardcopy billing forms, formats, and filling requirements

Bottomline, bringing in the money owed for services rendered as quickly as possible and as efficient as possible.  Keep the revenue cycle as short as humanly possible.

Candidate Differentiators!

  • Understanding of CPT, HCPCS, Revenue Codes, ICD-10 diagnosis and procedure coding guidelines
  • Knowledge of HIPAA rules and regulations
  • Preferred knowledge of medical terminology, CPT/HCPCS/UB04 revenue coding, modifiers, and billing regulations, documentation standards, fee schedules, third party billing and documentation standards
  • Experience & knowledge of functions & activities of medical offices/hospitals, understanding of compliance, knowledge of various payment systems, skill in researching and resolving problems and issues
  • You will need working knowledge of Microsoft Outlook, Word, Excel and practice management systems
  • Communication is important so written and oral communication skills will be verified 

The information above is just the highlights, and it is a career move because of the incredible leadership team they have assembled. Don't miss out on this opportunity; it is a career move and not just another job.