What are the responsibilities and job description for the Medicaid Billing Specialist position at GHC LTC Management LLC?
Gemini Healthcare, LLC is seeking an experienced Medicaid Biller to join our Corporate Accounts Receivable team. This position is responsible for managing all aspects of Medicaid billing for our Long Term Care and Skilled Nursing facilities while ensuring compliance with Texas Medicaid regulations and company policies.
The ideal candidate will have 3–5 years of recent Long Term Care Medicaid billing experience, possess exceptional organizational skills, and thrive in a fast-paced environment where multitasking and attention to detail are essential. This position works directly with the Accounts Receivable Director and plays a critical role in maintaining accurate billing, maximizing reimbursement, and supporting facility operations.
This is an on-site position located in Forth Worth, TX.
Essential Duties and Responsibilities
- Prepare, review, and submit Medicaid claims accurately and timely.
- Ensure all billing activities comply with Texas Medicaid regulations and applicable federal guidelines.
- Verify resident Medicaid eligibility and maintain accurate payer information.
- Work closely with facility Business Office Managers to ensure resident documentation is complete and supports billing requirements.
- Monitor claim status, identify billing issues, resolve denials, and follow claims through payment.
- Research and resolve outstanding accounts and reimbursement discrepancies.
- Maintain organized and up-to-date resident billing files and supporting documentation.
- Generate billing, aging, and reimbursement reports for the Accounts Receivable Director and leadership team.
- Communicate effectively with state agencies, managed care organizations, facility staff, and corporate personnel.
- Assist with Medicaid pending accounts and eligibility issues.
- Monitor regulatory changes and implement updates to billing processes as needed.
- Meet established billing deadlines while managing multiple priorities.
- Participate in audits and provide requested documentation when needed.
- Perform additional duties as assigned by the Accounts Receivable Director.
Qualifications
Required Experience
- Minimum of 3–5 years of Medicaid billing experience in a Long Term Care or Skilled Nursing Facility setting is required.
- Experience working with Texas Medicaid programs and reimbursement processes.
- Proven ability to manage high-volume billing with accuracy and efficiency.
Knowledge and Skills
- Thorough knowledge of Texas Medicaid regulations, eligibility, billing, and reimbursement requirements.
- Strong understanding of Long Term Care revenue cycle management.
- Proficiency with Medicaid billing software and Microsoft Office Suite, including Excel and Outlook.
- Excellent analytical and problem-solving skills.
- Exceptional attention to detail and organizational abilities.
- Ability to prioritize tasks, meet deadlines, and multitask in a fast-paced environment.
- Strong written and verbal communication skills.
- Ability to work independently while collaborating effectively with corporate and facility teams.
- Professional, dependable, and able to maintain confidentiality.
Physical Requirements
- Ability to sit for extended periods while working on a computer.
- Ability to occasionally lift up to 20 pounds.
- Regular use of office equipment including computers, phones, and printers.
Work Environment
This position requires daily on-site attendance at be able to reliably commute to the corporate office. Remote or hybrid work is not available for this role.