Medicaid Billing Specialist II

Description

Get FIRED up Chicago! Ignite Medical Resorts Home Office in Park Ridge, Illinois is HIRING a Medicaid Billing Specialist II.

SUMMARY: Reporting directly to the Director of Central Billing, the Medicaid Billing Specialist II is responsible for managing Medicaid billing and collections with increased independence and accountability. This role ensures the accuracy of claims, adjustments, and receivables while identifying and resolving discrepancies that impact reimbursement. The Medicaid Billing Specialist II works closely with facility Business Office Managers to address eligibility and authorization issues, provides training support to Specialist I staff, and contributes to departmental performance by monitoring trends, documenting payer activity, and participating in AR reviews

Essential Duties and Responsibilities:

· Prepares and submits all Medicaid billing, turnaround documents and claim adjustments.

· Communicates closely with facility Business Office Manager to ascertain status of pending applications, level of care determinations and re-certifications.

· Utilizes company approved system to document and follow up on payer commitments

· Identifies payment discrepancies and unpaid claims; takes appropriate action to resolve balance.

· Prepares A/R adjustments and corrections as needed.

· Identifies, researches and resolves credit balances according to policy and payer requirements.

· Identifies adverse facility trends resulting in returned or denied claims (e.g., repeated failure to obtain prior authorization) and communicates to Business Office Manager for follow-up.

· Reports status of claims and AR balances to supervisor, upon demand and/or according to established schedule and procedures.

· Participates in monthly AR review.

· Prepares account write-off when collection efforts exhaust and submits to supervisor.

· Assists with training and orientation of Medicaid Billing Specialist I.

Other Duties: Please note this job description is not designed to cover or contain a comprehensive list of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

If you are dedicated, compassionate, dependable and energetic – WE WANT YOU!

Awesome Benefits that Ignite Team Members can expect:

· GENEROUS BENEFITS PACKAGE INCLUDING HEALTH, DENTAL & VISION

· 401K PLAN WITH EMPLOYER MATCH

· PAID TIME OFF

· HOLIDAY PAY

· VOLUNTARY BENEFITS - LIFE/AD&D, STD, LTD, CRITICAL ILLNESS, ACCIDENT, HOSPITAL INDEMNITY

· SHORT-TERM AND LONG-TERM DISABILITY

· EMPLOYEE ASSISTANCE PROGRAM (EAP)

· HEALTH SAVINGS ACCOUNT (HSA)

· EMPLOYER PAID LIFE INSURANCE

· RASMUSSEN COLLEGE 20% DISCOUNT FOR IN PERSON CLASSES

· HOSPITALITY AND TEAMWORK FOCUSED CULTURE

· 50% OFF IN OUR ON-SITE RESTAURANT AND LUXECAFE PROUDLY SERVING STARBUCKS

· A COMMITMENT TO TECHNOLOGY

· FREE PLANET FITNESS MEMBERSHIP

· ON DEMAND PAY

· COMPANY SPONSORED DOORDASH DELIVERY SERVICE

· ADVANCEMENT OPPORTUNITIES

· SUPER PERKS PROGRAM PET INSURANCE 12%-30% DISCOUNTS

· SUBSIDIZED CHILD CARE BENEFITS

Ignite Medical Resorts is an Equal Opportunity Employer.

Requirements

QUALIFICATIONS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements below are representative of the knowledge, skill, and/or ability required.

· High school diploma or G.E.D.

· Minimum of three (3) years’ experience in health care insurance billing, preferably for skilled nursing facility providers.

· Comprehensive knowledge of Medicaid programs, including eligibility criteria, covered services, billing rules, recipient rights and provider responsibilities

· Must be able to read, write, speak, and understand the English language.

· Excellent interpersonal skills

· Ability to manage, analyze and reconcile billing and payment details.

· Ability to work well in a team-oriented, cooperative environment.

· Strong organizational skills and communication skills.

PHYSICAL DEMANDS: The physical demands are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

· Be able to move intermittently throughout the workday.

· Must be able to cope with the mental & emotional stress of the position

· Must be able to push, pull, move, and/or lift a minimum of 25 pounds to a minimum height of 5 feet and able to push, pull, move, and/or carry such weight a minimum distance of 50 feet.