Medicaid Specialist, Potential Remote
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Job Location:
Louisville, KY - USA
Monthly Salary:
Not Disclosed
Posted on:
30+ days ago
Vacancies:
1 Vacancy
Job Summary
Primary Location:
250 E Liberty StAddress:
250 East Liberty St. Louisville KY 40202Shift:
First Shift (United States of America)Job Description Summary:
Job Description:
This position requires thorough knowledge of the Uniform Bill Medicaid Medicare and Medicare Advantage billing secondary deductible/coinsurance billing and the Direct Data Entry (DDE) system for follow up. The specialist performs all duties related to timely and efficient billing and follow-up using their thorough understanding of Medicaid eligibility benefits determining primary payer and covered benefits.Additional Job Description:
Essential Functions
- Monitor and resolve claims holding on discharged not final billed (DNFB) list.
- Assure all claims are filed electronically except for some paper claims.
- Process claims identified from insurance discovery.
- Submit account for appeal on accounts where retroactive coverage has been obtained.
- Identify payers being submitted on paper rather than electronically and communicate the opportunities to leadership.
- Follow up on unpaid Medicaid and Managed Medicaid claims in a timely manner.
- High dollar accounts will have consistent follow up until the account has been resolved.
- Responsible for reviewing and understanding explanation of benefits/remittance advice.
- Assure statements are generated for the patient responsibility amounts.
- Utilize insurance websites to view and resolve claims.
- Perform extensive account follow-up and provide analysis of problem accounts.
- Document all follow up efforts in a clear and concise manner into the AR system.
- Compliance with State and Federal Regulations.
- Audit research accounts payment posting contractuals to confirm the accuracy of the balance of the account.
- Assure medical record requests are documented and submitted in a timely manner.
- Collaborate with denials team on difficult or reoccurring denials.
- Complete tasks by deadline.
- Identify and report all trends that may provide insight into payment challenges.
- Phone contact with patient physician office attorney etc. for additional information to process the claim.
- Work assigned accounts as directed while reaching daily productivity goals.
- Attend seminars as requested.
- Other duties as assigned.
Skills Knowledge or Abilities critical to this role:
- Working knowledge of medical and insurance terms.
- Ability to review comprehend discuss HCFA billing with Insurance or Government agencies.
- Knowledge of general insurance requirements.
- Experience working directly with EOBs and contractual adjustments.
Required Experience:
IC
Key Skills
- Sales Experience
- Crane
- Customer Service
- Communication skills
- Heavy Equipment Operation
- Microsoft Word
- Case Management
- OSHA
- Team Management
- Catheterization
- Microsoft Outlook Calendar
- EHS
About Company
UofL Health provides comprehensive care at our UofL Health – UofL Hospital location in Louisville Ky. Learn more about UofL Health – UofL Hospital and the various services we provide.
