The Medicaid Team is responsible for the daily billing and follow up of all Medicaid accounts receivable. Daily billing includes timely and thorough review and resolution of all billing edits, errors, and rejections. Timely follow up of all unresolved accounts receivable is required and includes reviewing and appealing all technical denials and escalating clinical appeals to the appropriate area for resolution. Good customer service skills are required to assist patients and internal customers with all concerns and questions.

Required Knowledge & Skills

Education: High School Diploma or GED

Experience: Two years of related experience. Requires working knowledge of specialized practices, equipment, and procedures.

Licenses and Certifications

NONE REQUIRED

Supervision

No supervisory responsibilities.

Qualifications

Two (2) years experience in Medicaid billing and collections in a hospital, clinic, or physician's office setting preferred. Experience working and resolving billing edits, errors and rejections and various claim denials. Customer service skills required as this position involves interaction with patients and various internal departments.

Business -like appearance.

Ability to work closely with others, and function as a team member.

Ability to analyze and prioritize workloads.

Proficiency in spelling, business letter writing, and medical terminology.

Knowledge of electronic documents and spreadsheets. Preferred qualifications includes MS Word and Excel.

Detail oriented.

Assertive without being abrasive.

Good verbal and written communication skills.

Working knowledge of GAMMIS and Alabama Medicaid websites. May also require knowledge of Medicaid CMO websites.

Ability to speak with and follow through with insurance companies to review or obtain pre-certifications, authorizations or referrals.

Working knowledge of ICD diagnosis, HCPCS CPT or procedure codes and how they correlate with payment for all hospital services.

Understanding of billing issues, denial trends and payer claim requirements and communicate this information to various internal departments in order to resolve unpaid or held accounts.

Knowledge of registration data elements is required to correct eligibility and claim errors.

Monday - Friday, 8:00am - 4:30pm