medicaid billing specialist

Trilogy Quality Assurance

<p><b>Job Overview</b><br/>We are seeking a detail-oriented and energetic Billing Specialist with Home Health experience to join our dynamic healthcare team. In this role, you will be responsible for managing the billing process for home health services, ensuring accurate and timely submission of claims, and maintaining compliance with industry standards. Your expertise will help optimize revenue cycles while providing exceptional support to our healthcare providers and patients. If you thrive in a fast-paced environment and have a passion for healthcare billing, this is an excellent opportunity to make a meaningful impact.</p><p><b>Responsibilities</b></p><ul><li>Prepare and submit medical claims using appropriate coding systems such as CPT (Current Procedural Terminology), ICD-9, ICD-10, and DRG (Diagnosis-Related Group) classifications.</li><li>Must have experience with Kentucky Medicaid, Medicare Advantage, Medicaid Advantage, Commercial.</li><li>Cash Posting, Billing reports</li><li>Utilize EMR (Electronic Medical Records) and EHR (Electronic Health Records) systems to access patient information and process billing transactions efficiently.</li><li>Verify insurance coverage, benefits, and authorizations to facilitate smooth claim processing.</li><li>Follow up on unpaid or denied claims through medical collections processes, working diligently to resolve discrepancies.</li><li>Maintain detailed records of billing activities, claim submissions, adjustments, and payments for audit purposes.</li><li>Stay current with industry regulations, coding updates, and payer policies to ensure compliance and maximize reimbursement.</li></ul><p><b>Experience</b></p><ul><li>Proven experience in medical billing within a home health setting is required, Palliative and Hospice experience a plus</li><li>Strong knowledge of medical coding including CPT coding, ICD-9, ICD-10, ICD coding, and DRG classifications.</li><li>Familiarity with medical terminology, medical records management, and the intricacies of medical office workflows.</li><li>Hands-on experience with EMR/EHR systems used in home health agencies or similar healthcare environments.</li><li>Demonstrated ability to handle medical collections effectively while maintaining professionalism.</li><li>Excellent attention to detail combined with strong organizational skills to manage multiple billing tasks simultaneously.</li><li>Prior experience working with Medicare, Medicaid, or private insurance payers is highly preferred. Join us in delivering exceptional healthcare services by ensuring accurate billing processes that support our mission of compassionate patient care!</li></ul><p>Pay: $21.50 - $24.50 per hour</p><p>Work Location: Remote</p>

Billing Specialist- Home Health- Kentucky Medicaid experience REQUIRED

DePaul Community Resources

<div><div><div><b>Benefits:</b></div>
<ul><li>Dental insurance</li>
<li>Health insurance</li>
<li>Paid time off</li>
<li>Vision insurance</li>
</ul></div><div><div><b>ADS Billing and Payroll Specialist</b><br>
<br>
<b>Level of Education: </b>High school diploma or G.E.D<br>
<b>Job Type:</b> Full-Time/Regular (37.5 hours workweek)</div>
<div><b>Years of Experience:</b> Any</div>
<div><b>Location:</b> Roanoke</div>
<div>
<br>
<b>JOB SUMMARY:</b>
</div><div>The ADS Billing and Payroll Specialist position supports the Finance Department and Operational staff in the Agency Directed Services (ADS) Division. This position is responsible for the daily billing and collections for ADS and associated payments to Caregivers. The ADS Billing and Payroll Specialist will also play a critical role in supporting the Medicaid/MCO service authorization process and maintaining accurate credentialing records for ADS within our organization as needed. The ADS Billing and Payroll Specialist will maintain all payable records for all Caregivers, as well.</div>
<div></div>
<div>The ADS Billing and Payroll specialist must build relationships and work with all Finance team members, other DePaul staff at all levels of the organization, and multiple partner agencies and third-party payors of DePaul&rsquo;s services.
</div>
<div></div><div>This position is primarily remote work, but must be able to commute to the Roanoke office twice per week if needed.</div>
<div></div>
<div><b>SUPERVISION RECEIVED AND EXERCISED:</b></div>
<div>The ADS Billing and Payment Specialist reports directly to the Accounting Supervisor.
</div>
<div></div><div><b>ESSENTIAL FUNCTIONS AND DUTIES:</b></div>
<div>This list is not an exhaustive &amp; all-inclusive list of job responsibilities. The distribution of time allotted for any function or duty is subject to change with or without notice. Nothing in this job description restricts management's right to assign other responsibilities to this job or reassign them elsewhere at any time.</div>
<div>
<br>
<b>Billing and Accounts Receivable Management:</b>
</div><ul><li>Collaborate and work cross-functionally with other finance and ADS Program staff to ensure billing is complete, accurate, and collectible.</li>
<li>Complete / Upload billing for ADS in Sage 100 weekly.</li>
<li>Ensure accurate and timely weekly submission of applicable ADS billing to all third-party payers (Medicaid, MCOs, individual clients, etc.).</li>
<li>Process cash receipts in Sage 100 for ADS daily.</li>
<li>Monitor Accounts Receivable and take necessary steps to collect outstanding balances.</li>
<li>Work with all payers, including insurance carriers, other organizations, DePaul staff, and clients, to resolve billing issues promptly.</li>
<li>Research any past-due balances, unpaid and underpaid; follow up on any denials of payment and determine a resolution that includes corrected claims, disputes, and appeals.</li>
<li>Communicate with ADS staff regarding denials that require client intervention to receive reimbursement.</li>
</ul><div><b>Accounts Payable Management (for Caregivers):</b></div>
<ul><li>Ensure all paperwork for ADS Caregivers regarding compensation is acquired and maintained in accordance with approved policies and procedures.</li>
<li>Review EVV time punches for accuracy related to approved Service Authorizations and related scheduling.</li>
<li>Present payment information to ADS leadership for review and approval prior to processing associated payments.</li>
<li>Prepare and upload payment information for ADS Caregivers into Sage 100 on an as-needed basis.</li>
<li>Work with DePaul Accounts Payable to ensure payments are made in accordance with the approved payment schedule for ADS Caregivers.</li>
</ul><div><b>Communication and Collaboration:</b></div>
<ul><li>Act as a main point of contact for questions related to the billing or payment of services for ADS.</li>
<li>Communicate effectively with internal teams and external agencies to resolve authorization or credentialing issues.</li>
<li>Collaborate with other departments to streamline processes and improve efficiency in authorization and credentialing workflows, as well as associated billing and payments.</li>
</ul><div><b>Service Authorization Backup Support:</b></div>
<ul><li>Assist with the authorization process for services rendered to Medicaid and MCO beneficiaries.</li>
<li>Collaborate with ADS Staff to gather necessary documentation for authorization requests, when needed.</li>
<li>Monitor authorization timelines and ensure adherence to regulatory standards.</li>
<li>Keep abreast of changes in Medicaid and MCO regulations and update internal processes accordingly.</li>
</ul><div><b>Credentialing Oversight Backup Support:</b></div>
<ul><li>Assist with the ADS credentialing and re-credentialing processes for DePaul Community Resources in accordance with Medicaid and MCO regulations, when needed.</li>
<li>Monitor and adapt to changes in Medicaid and MCO policies, procedures, and requirements related to credentialing.</li>
</ul><div><b>KNOWLEDGE, SKILLS, ABILITIES &amp; OTHER CHARACTERISTICS REQUIRED:</b>
</div><div>Knowledge, skills, abilities, and other characteristics or KSAOs are attributes needed to perform a job that is demonstrated through qualifying training, education, and experience. This list is not an exhaustive &amp; all-inclusive list of all KSAOs for this job.</div>
<div></div>
<div><b>Knowledge of:</b></div>
<ul><li>Healthcare terminology and Medicaid provider qualifications</li>
<li>Virginia Waiver Management Systems (WaMS)</li>
<li>Kepro/Atrezzo/Acentra portal</li>
<li>Availity portal</li>
<li>MCO portals</li>
<li>Virginia Medicaid Enterprise System (MES)</li>
<li>Credentialing process for Virginia Medicaid Managed Care Organizations (MCOs)</li>
<li>Service authorizations and insurance verifications</li>
<li>Office and records administration techniques and procedures.</li>
<li>Office procedures and spelling, grammar, punctuation, and arithmetic.</li>
<li>The structure and content of the English language, including the meaning and spelling of words, rules of composition, and grammar.</li>
<li>Microsoft Office Word, Excel, PowerPoint, Outlook, SharePoint, Teams, and virtual meeting applications such as Zoom.</li>
<li>DePaul's policies, procedures, and standard practices and the rules and guidelines established by regulatory and governing agencies such as DBHDS (Department of Behavioral Health &amp; Developmental Services), HCBS (Home Community Based Services, HSAG (Health Services Advisory Group), DSS (Department of Social Services, and DMAS (Department of Medical Assistance Services)</li>
<li>Policies, procedures, and strategies that promote the safety and protection of people, data, and property.</li>
</ul><div><b>Skill in/Ability to:</b></div>
<ul><li>Proficiency in using database systems and software for credentialing and authorization processes.</li>
<li>Work independently and collaboratively in a fast-paced environment while maintaining accuracy and attention to detail.</li>
<li>Complete required training as needed and assigned.</li>
<li>Give full attention to what other people are saying, take time to understand the points being made, ask questions as appropriate, and not interrupt at inappropriate times.</li>
<li>Demonstrate verbal and written communication and body language that conveys information, ideas, or inquiries effectively and concisely that purveys professional composure, emotional intelligence, thoughtfulness, patience, and respect amidst change, ambiguity, and within the daily trajectories of work.</li>
<li>Operate standard office equipment such as telephone, calculator, printer, scanner, cellular phone, tablet, computer, postage machine, shredder.</li>
<li>Demonstrate logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions, or approaches to problems.</li>
<li>Collect and analyze data.</li>
<li>Manage multiple priorities and complete assignments on time, accurately, and with attention to detail, and ensure a high-quality work product.</li>
<li>Work collaboratively within a team environment and build strategic relations with coworkers, management, and community partners.</li>
<li>Communicate effectively in both oral and written form.</li>
<li>Develop objectives, evaluate effectiveness, and assess needs.</li>
<li>Recognize, analyze, and problem-solve ambiguous or difficult situations and questions using critical thinking while maintaining professional composure.</li>
</ul><div><b>Other Characteristics:</b></div>
<ul><li>Demonstrate self-awareness, ongoing self-evaluation, and a commitment to being part of a diverse, equitable, respectful, and inclusive workplace where all people are valued.</li>
<li>Demonstrate professional composure in difficult and stressful situations.</li>
<li>Demonstrate the FIRST (fairness, integrity, respect, safety, trust) values in the daily trajectories of work.</li>
<li>Demonstrate professionalism regarding access to sensitive and confidential information related to employees, clients, and business records with no disclosure to others without needing to know.</li>
</ul><div><b>MINIMUM REQUIREMENTS TO APPLY:</b></div>
<ul><li>High school diploma or G.E.D. required.</li>
<li>Preferred education in Healthcare Administration, Human Services, or a related field, or equivalent work experience.</li>
<li>Experience working with Medicaid regulations, preferably in service authorization, credentialing, and billing.</li>
</ul><div><b>WORK ENVIRONMENT:</b></div>
<div>The work environment characteristics described herein represent those an employee encounters while performing the position's essential functions. The employee regularly works in an office environment and occasionally in the field. Work is generally completed regularly during weekdays; however, daily work hours may vary. Completion of job duties outside of normally scheduled hours may be required. Work is subject to frequent interruptions, and noise levels are varied based on the work locations.</div>
<div></div>
<div><b>PHYSICAL REQUIREMENTS:</b></div>
<div>The physical demands described herein are representative of those that an employee in this position must meet, with or without reasonable accommodations, to perform the essential functions successfully. Physical activities required are finger dexterity necessary to operate equipment used in the position, effective communication, and seeing or hearing verbal cues. Walking for up to one-third of the time, sitting two-thirds or more of the time, standing for up to one-third of the time, bending from one-third to two-thirds of the time, stooping for up to one-third of the time, lifting/pushing/pulling no more than ten pounds is required. When accessing various locations, the incumbent must climb stairs and ramps. This position requires driving approximately ten percent of the employee's working time to various locations. Public transportation may not be available. Individuals needing reasonable accommodations should speak with their immediate supervisor/hiring manager.</div>
<div></div>
<div><b>SPECIAL REQUIREMENTS AND QUALIFICATIONS:</b></div>
<div>Successful completion (per DePaul's policies) of a Motor Vehicle Record, Criminal and Child Protective Services Background Report, and Drug Test is required. An unsatisfactory result of any of these tests will terminate the application process.</div>
<div></div>
<div><b>NOTE:</b></div>
<div>This description provides information regarding the essential functions of the designated job and the general nature and level of work associated with the job. It should not be interpreted to describe all the duties whose performance may be required of such employees or be used to limit the nature and extent of assignments such an individual may be given.</div>
<div><br>
<b>DePaul is an equal-opportunity employer and E-Verify Participant.</b>
</div>
</div><p>Flexible work from home options available.</p></div>

ADS Billing and Payroll Specialist

United and Empowered Care, Inc.

<div><p>Sign-On Bonus: Up to $500!</p>
<ul>
<li>$250 after 90 days</li>
<li>Additional $250 after 6 months</li>
</ul>
<p>Compensation starts at $17 - $18/hour(based on experience and qualifications)</p>
<p>
Duties and Responsibilities</p>
<ul>
<li>Verify Medicaid and other insurance eligibility through electronic systems and online payer portals.</li>
<li>Remain informed about changes and updates to guidelines and regulations related to Medicaid Waiver Services billing and communicate relevant updates to management as necessary.</li>
<li>Update and maintain Client Billing Information Sheets with new authorizations and other required information using secure company databases or electronic record systems.</li>
<li>Verify clients, tiers, and authorization dates monthly with department heads through virtual communication methods such as email, secure messaging, or video meetings.</li>
<li>Track weekly service hours for all clients and enter data into electronic billing logs for each program.</li>
<li>Prepare, review, and transmit claims through Medicaid and other insurance billing software using secure remote system access.</li>
<li>Update and maintain billing logs with current service rates and procedure codes to ensure accurate claim submission.</li>
<li>Monitor denied claims, research causes for denial, and submit appeals or corrections in a timely manner through payer portals or billing software.</li>
<li>Prepare and submit weekly reports regarding pending claims and claim status to management via email or shared reporting systems.</li>
<li>Maintain strict confidentiality and security of client information in compliance with HIPAA (Health Insurance Portability and Accountability Act) regulations and organizational policies while working remotely.</li>
<li>Ensure compliance with company policies regarding secure remote access, password protection, and proper handling of electronic records.</li></ul></div>

Medical Biller

Oregon Health & Science University

<div>Department Overview:
<p>
The purpose of this position is to secure reimbursement for services rendered to uninsured and/or underinsured patients by assisting individuals in accessing and/or applying for any Medicaid or other Federal or State assistance programs, or for other forms of sponsorship for which they might qualify. The result of this activity is new and continued reimbursement for medical care services. Performs requirements for staff members as outlined in Compliance Roles and Responsibilities in OHSU Hospitals and Clinics.</p>
Function/Duties of Position:
<ul><li>Conducts on-site Medicaid program intakes in both English and Spanish, forwarding applications and supporting documentation to appropriate Medicaid office, Aging and People with Disabilities office (APD), and other state Department of Human Services (DHS) offices as appropriate.</li><li>
Assists potential eligible clients or their representatives in the application process with the appropriate public assistance office, monitoring, advising, interviewing and advocating as appropriate throughout the application process from initial application through formal decision.</li><li>
Monitors decisions of approval to ensure accuracy of program and medical effective date and decisions of denial assuring appropriateness of agency action.</li><li>
Counsels referred patients delineating State medical coverage versus personal liability.
</li><li>Assesses patients for waivered or placement services, coordinating the process with OHSU Care Management, Medicaid agency staff and providers of the waivered services or nursing home placement staff for successful and timely discharges for inpatients and service plan and placements post discharge.</li><li>
Evaluates and advises patients and family members in accessing hospital and community services by consulting and making referrals to social workers, patient care coordinators, nursing home liaisons, outside agencies and legal services.</li><li>
When information gathered discloses that a patient has insurance, gathers information, codes and transfers account to the Insurance Verification Specialists for insurance verification and authorization.</li><li>
For patients/guarantors disclosing difficulty in paying their bill, and after assessing all other possible funding sources such as COBRA, Medicaid, etc., initiates application under the OHSU Financial Allowance Policy.</li><li>
Provides assistance to other internal and external eligibility staff and to miscellaneous hospital staff regarding Oregon Medicaid programs administered through DHS; provides interpretation of the state&rsquo;s DHS computer screens; provides assistance regarding programs of the Social Security Administration.</li><li>
Provides assistance related to managed care, indemnity plans, Medicare and other insurance plans.</li><li>
Actively identifies, on a continuous basis, Medicaid program changes, problematic policy issues and procedural requirements relative to state and federal programs that impact patients and the hospital.
</li><li>Other duties as assigned.</li></ul>
Required Qualifications:
<ul><li><p>
A minimum of one year of recent experience in determining Medicaid eligibility; <b>OR</b></p></li><li><p>
Three years of any combination of determining eligibility for public assistance programs. Recent experience is defined as within the last five years.</p></li><li><p>
An undergraduate degree will substitute for one years of Medicaid experience.</p></li><li><p>
Preference is given to applicants who have experience determining eligibility for Medicaid applicants/recipients.</p></li></ul><p><b>
Knowledge, Skills, and Abilities</b></p><ul><li>
Extensive knowledge of statutes, regulations, policies, procedures and guidelines of assistance programs administered by DHS agencies and the Social Security Administration as well as community programs available to patients in need.</li><li>
Extensive knowledge regarding confidentiality, privileged communication and professional ethics, including advocacy techniques.</li><li>
Extensive knowledge of the Medicaid eligibility systems and other information systems, personal computers and office equipment. Knowledge of medical terminology.</li><li>
Skill in interpreting and applying Federal &amp; State rules and regulations, policies and procedures for Medicaid, disability programs &amp; Health Insurance Portability and Accountability Act (HIPAA).</li><li>
Skill in casework methods and techniques including communication with and assessing the needs of individuals with physical and mental disabilities, the elderly and disease processes.</li><li>
Skill in verbal and written communication with patients/clients and collateral resources of various socioeconomic backgrounds.</li><li>
Skill in prioritizing and managing work time and efforts to accomplish both ongoing and emergent duties. Skill in maintaining composure and working objectively with patients/clients who may be hostile or verbally abusive.</li><li>
Skill in maintaining harmonious working relationships.</li><li>
Must have demonstrable record of reliable attendance, exemplary customer contact skills, punctuality, and proven successful performance at most recent past and present employers.</li></ul><p><b>
Certifications</b></p><ul><li><p>
Must complete certification as a Medicaid Application Assister (for both Oregon and Washington) within 3 months of employment, which includes a background check through the State of Oregon. Must be able to maintain certification annually.</p></li><li><p>
Certificate of Successful completion in Spanish Language, issued by OHSU Translation and Interpreter Services Department&rsquo;s current process.</p></li></ul>
Preferred Qualifications:
<ul><li>Undergraduate Degree.</li><li>
A minimum of three years of recent experience in determining Medicaid eligibility.</li></ul>
Additional Details:
<p>
Hybrid remote, Monday - Friday, 9:30am - 6:00pm. Work from home days must be Tuesdays, Wednesdays, or Thursdays.</p><p></p><p><br>
Regular contact with patients both in office and in a clinical setting.</p><p>
Occasional contact with hostile or angry patients or family members.</p><p></p><p><b><br>
Benefits</b></p><ul><li><p>
Healthcare for full-time employees covered 100% and 88% for dependents.</p></li><li><p>
$50K of term life insurance provided at no cost to the employee.</p></li><li><p>
Two separate above market pension plans to choose from.</p></li><li><p>
Vacation - up to 200 hours per year dependent on length of service.</p></li><li><p>
Sick Leave - up to 96 hours per year.</p></li><li><p>
9 paid holidays per year.</p></li><li><p>
Substantial Tri-Met and C-Tran discounts.</p></li><li><p>
Employee Assistance Program.</p></li><li><p>
Childcare service discounts.</p></li><li><p>
Tuition reimbursement.</p></li><li><p>
Employee discounts to local and national businesses.</p></li></ul>
Why apply to OHSU?: <b>We are Oregon's only public academic health center.</b> In addition to caring for patients, we lead groundbreaking research. We also train the next generation of health care professionals. As Portland's largest employer, we give you opportunities to learn and advance in a system of hospitals and clinics across Oregon and Southwest Washington. <b>All are welcome.</b> OHSU welcomes people of all ages, ethnicities, genders, national origins, religions and sexual orientations. We are striving to build an anti-racist, multicultural institution and encourage people with diverse backgrounds to apply. To request reasonable accommodation, contact askhr@ohsu.edu</div>

Medicaid Specialist

Rochester Regional Health

<div><p><b>Job Title: </b>Medical Billing &amp; Denials Specialist<br>
<b>Department:</b> Patient Financial Services<br>
<b>Location: SLH - </b>Regional Administrative Campus<br>
<b>Hours Per Week: </b>37.5<br>
<b>Schedule: </b>8am-4pm</p><p></p><p><b><br>
SUMMARY:</b></p><p><b>
</b> A Medical Billing and Denials Specialist is responsible for managing the billing process, submitting claims to insurance companies, following up on unpaid or denied claims, and ensuring timely reimbursement for healthcare services. This role plays a critical part in the revenue cycle management of the healthcare organization by identifying trends in denials and taking corrective actions.</p><p></p><p><b>
RESPONSIBILITIES:</b></p><ul><li><p><b>
Medical Billing &amp; Claims Management</b>: Submit and track insurance claims, resolve denials and billing edits, process remittances and adjustments, and ensure timely and accurate account resolution in line with payer requirements.</p></li><li><p><b>
Appeals &amp; Reimbursement Review</b>: Conduct detailed reviews of denied or underpaid claims, prepare appeal letters, gather supporting documentation, and collaborate across departments to ensure successful claim outcomes.</p></li><li><p><b>
Customer Service &amp; Communication</b>: Respond to patient inquiries, verify insurance eligibility and authorizations, and maintain thorough documentation while ensuring clear communication across Revenue Cycle teams.</p></li><li><p><b>
Compliance &amp; Operational Excellence</b>: Maintain HIPAA confidentiality, meet productivity benchmarks, stay current with billing policies, and manage workload with strong time management, organization, and communication skills.</p></li></ul><p></p><p><b><br>
PREFERRED QUALIFICATIONS:</b></p><ul><li><p>
High school graduate or equivalent</p></li><li><p>
Bachelor&rsquo;s degree in healthcare or business administration</p></li><li><p>
Minimum 1 year medical billing and denials, customer service and relevant finance experience in a health care organization a plus
</p></li><li><p>Certification in medical billing
</p></li></ul><p></p><p><b>UNION:</b></p>
1199-200B Clerical Workers (CPH)<p><i>
Note: </i><i>Not all per diem roles are union eligible</i></p><p></p><p><b>
EDUCATION:</b></p><p></p><p><b>
LICENSES / </b><b>CERTIFICATIONS:</b></p><p></p><p><b>
PHYSICAL REQUIREMENTS:</b></p>
S - Sedentary Work - Exerting up to 10 pounds of force occasionally Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.<p></p><p><b>
For disease specific care programs refer to the program specific requirements of the department for further specifications on experience and educational expectations, including continuing education requirements.</b><b>
</b></p><p></p><p><b>Any physical requirements reported by a prospective employee and/or employee&rsquo;s physician or delegate will be considered for accommodations.
</b></p><p></p><p><b>PAY RANGE:</b></p>
$20.66 - $29.99<p></p><p><i>
The listed base pay range is a good faith representation of current potential base pay for a successful full time applicant. It may be modified in the future and eligible for additional pay components. Pay is determined by factors including experience, relevant qualifications, specialty, internal equity, location, and contracts.</i><b>
</b></p><p></p><p><b>Rochester Regional Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, sex (including pregnancy, childbirth, and related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, predisposing genetic characteristics, marital or familial status, military or veteran status, citizenship or immigration status, or any other characteristic protected by federal, state, or local law.</b></p></div>

Medical Billing & Denials Specialist

Wipro

<div>Job Description<p></p><div><div><ul><li><div><b><br>
</b><br>
</div></li></ul></div></div><div><div><div><div>Job Title: Medicaid Business Analyst
</div></div></div></div><div><div><div><div>City: Jefferson City
</div></div></div></div><div><div><div><div>State/Province: Missouri
</div></div></div></div><div><div><div><div>Posting Start Date: 3/11/26
</div></div></div></div><div><div><div><div>Wipro Limited (NYSE: WIT, BSE: 507685, NSE: WIPRO) is a leading technology services and consulting company focused on building innovative solutions that address clients&rsquo; most complex digital transformation needs. Leveraging our holistic portfolio of capabilities in consulting, design, engineering, and operations, we help clients realize their boldest ambitions and build future-ready, sustainable businesses. With over 230,000 employees and business partners across 65 countries, we deliver on the promise of helping our customers, colleagues, and communities thrive in an ever-changing world. For additional information, visit us at www.wipro.com.
</div></div></div></div><div><div><div><div>Job Description:
<div><div><div><h2 class="jobSectionHeader"><b>Job Description
</b></h2></div><div><div><b>Position Title: Business Analyst
</b></div><div><b>Work Location: Jefferson City, MO<br>
</b></div><div></div><div><b>Job Description:
</b></div><div>We are seeking a Senior Business Analyst with deep Medicaid domain expertise to lead complex initiatives. The Business Analyst (BA) will collaborate with various departments and stakeholders to gather, document, and analyze business requirements, processes, and workflows. They will translate these requirements into functional specifications for technology teams and work closely with project managers, developers, and testers to ensure successful project delivery. The BA will also be involved in identifying areas for process improvement and recommending solutions to enhance operational efficiency and effectiveness.
</div></div></div><div><div><h2 class="jobSectionHeader"><b>͏
</b></h2></div><div><div><b>The BA is responsible for the following:
</b></div><ul><li>Facilitating requirements gathering activities, including requirements and design meetings with the customer to discuss system task requests (STRs), enhancements, and project assessment quotations (PAQs) requirements.
</li><li>Lead requirements definition for complex Medicaid initiatives, including eligibility, enrollment, claims, benefits, etc.
</li><li>Act as a subject matter expert on Medicaid policy, regulations, and operational workflows.
</li><li>Partner with program leadership to analyze impacts of CMS and state policy changes.
</li><li>Guide and mentor junior and mid-level business analysts.
</li><li>Eliciting, analyzing, and documenting business and functional requirements, issues, and resolutions.
</li><li>Collaborate with technology teams to design solutions that meet business needs.
</li><li>Propose innovative and practical solutions to address business challenges.
</li><li>Ensure that proposed solutions align with the organization's strategic goals and technological capabilities.
</li></ul></div></div><div><div><h2 class="jobSectionHeader"><b>͏
</b></h2></div><div><ul><li>Serve as a liaison between business stakeholders and technology teams.
</li><li>Communicate complex technical concepts to non-technical stakeholders.
</li><li>Present findings, recommendations, and project updates to various audiences.
</li><li>Coordinating and facilitating the User Acceptance Test (UAT) with the business users and demo sessions and get sign-off on UAT.
</li><li>Creating new documentation or maintaining existing documentation on system changes.
</li><li>Analyzing and flagging potential issues and working with Technical Leads to manage any scope creep on the projects.
</li><li>Maintenance of reference files (Medical Criteria, Exception Control, etc) and rules authoring and testing within the Rules Management Application (RMA)
</li></ul></div></div><div><div><h2 class="jobSectionHeader"><b>͏
</b></h2></div><div><div><b>Experience/Skills:
</b></div><div><b>Qualified candidates will have the following:
</b></div><ul><li>Bachelor&rsquo;s degree in Business Administration or an equivalent in IT field preferred; demonstrated work experience may be considered in lieu of degree.
</li><li>Minimum of 8 years&rsquo; experience with customer relation activities, customer interface development, implementation, and maintenance of new or current policy including discussions with the customer about issues, desired outcomes, and solutions. Experience directly with Medicaid is required.
</li><li>Ability to independently lead and guide discussions with the customer, active listening skills, ability to facilitate decisions, attention to detail.
</li><li>Excellent writing, editing, and proofreading skills and command of the English language and grammar.
</li></ul></div></div><div><div><h2 class="jobSectionHeader"><b>͏
</b></h2></div><div><ul><li>Extensive experience in gathering business/functional user requirements, creating Use Cases as per user requirements, and documenting business requirements in formalized documents.
</li><li>Demonstrate ability to relay information clearly and concisely between technical and non-technical staff.
</li><li>Solid understanding of all phases of Software Development Life Cycle (SDLC) methodology (such as requirement, analysis, design, data modeling, business process modeling, implementation, and deployment).
</li><li>Proficient in Microsoft Office including Word and Excel.
</li></ul></div></div></div></div></div></div></div><div><div><div><div>Mandatory Skills: Health and Welfare (HW) .<br>
<p></p>Experience: 8-10 Years .<br>
<p></p>The expected compensation for this role ranges from $80,000 to $158,000 .<br>
<p></p>Final compensation will depend on various factors, including your geographical location, minimum wage obligations, skills, and relevant experience. Based on the position, the role is also eligible for Wipro's standard benefits including a full range of medical and dental benefits options, disability insurance, paid time off (inclusive of sick leave), other paid and unpaid leave options.<br>
<p></p>Applicants are advised that employment in some roles may be conditioned on successful completion of a post-offer drug screening, subject to applicable state law.<br>
<p></p>Wipro provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. Applications from veterans and people with disabilities are explicitly welcome.<br>
<p></p>Reinvent your world. We are building a modern Wipro. We are an end-to-end digital transformation partner with the boldest ambitions. To realize them, we need people inspired by reinvention. Of yourself, your career, and your skills. We want to see the constant evolution of our business and our industry. It has always been in our DNA - as the world around us changes, so do we. Join a business powered by purpose and a place that empowers you to design your own reinvention.</div></div></div></div></div><p></p>

Medicaid Business Analyst

Gentle Footcare

<p></p><div><p>Ohio Foot and Ankle Specialists is seeking a detail-oriented and dependable Billing Specialist to support accurate and timely medical billing operations. This role is responsible for claim submission, payment posting, follow-up, and ensuring compliance with payer requirements.</p>
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Essential Duties &amp; Responsibilities</b></h4><p>
Submit medical claims accurately and timely to insurance carriers</p>
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Review claims for completeness, accuracy, and compliance prior to submission</p>
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Post insurance payments, adjustments, and denials</p>
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Follow up on unpaid, underpaid, or denied claims</p>
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Research and resolve billing discrepancies</p>
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Work denied claims and submitted corrected or appealed claims as needed</p>
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Verify insurance benefits and billing requirements when necessary</p>
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Maintain compliance with billing regulations, payer guidelines, and company policies</p>
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Communicate professionally with insurance companies, internal teams, and leadership</p>
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Maintain patient confidentiality and HIPAA compliance</p>
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Perform other duties as assigned</p>
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Qualifications</b></h4><h4 class="jobSectionHeader"><b>
Medical billing experience preferred</b></h4><p>
Knowledge of CPT, ICD-10, and insurance billing processes preferred</p>
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Strong attention to detail and organizational skills</p>
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Ability to manage multiple tasks and meet deadlines</p>
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Basic computer proficiency and experience with EMR/practice management systems</p>
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Reliable attendance and professionalism</p>
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Benefits</b></h4><p>
Medical, Dental, and Vision Insurance</p>
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Paid Time Off (PTO)</p>
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Paid National Holidays</b></h4><p>
One (1) Floating Holiday</p>
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Work Environment</b></h4><h4 class="jobSectionHeader"><b>
Medical billing/administrative office setting</b></h4><p>
Prolonged periods of sitting and computer use</p>
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Interaction with internal teams, payers, and leadership</p>
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Equal Employment Opportunity Statement</b></h4><p>
Ohio Foot and Ankle Specialists is an Equal Opportunity Employer. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, genetic information, veteran status, or any other legally protected status.</p>
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About Gentle Footcare LLC</b></h4>
Ohio Foot and Ankle Specialists is the largest podiatry practice in Ohio, with over 40 providers in more than 30 locations across Ohio. We are continuing to grow throughout the state to provide premier care close to home. We utilize the latest technology in our practices, care for all age groups, and provide everything form routine care to complex surgery. Our vision is to become the leading provider of the podiatry services, with an outstanding physician team and staff delivering best -in -class patient outcomes</div><p></p>

Medical AR Billing Specialist

Search 10000+ Medicaid billing specialist jobs near you this March. New roles added regularly across leading industries. Apply today.