What are the responsibilities and job description for the Claims Specialist position at EMPOWER HEALTHCARE SOLUTIONS?
The claims specialist is responsible for the accuracy, timely processing, and adjudication of medical and behavioral health claims for members enrolled in the PASSE Medicaid program. The role ensures claims are processed in accordance with plan benefits, provider contracts, Arkansas Medicaid rules, and PASSE requirements, contributing to provider satisfaction and regulatory compliance.
Qualifications:
Education
- High school diploma or equivalent required.
- Associate degree or coursework in healthcare, business, or related field preferred.
Experience
- 1–3 years of experience in medical claims processing, billing, or healthcare customer service in a payer or provider environment.
- Experience with Medicaid and/or managed care preferred; PASSE, behavioral health, IDD, or LTSS experience a plus.