medicaid eligibility specialist

Staffing Solutions Organization LLC (SSO)

Staffing Solutions Organization LLC (SSO), an affiliate of Public Consulting Group LLC (PCG), is focused on delighting clients with world-class managed staffing and talent consulting services. SSO is committed to a diverse workforce, which is a reflection of our clients and the people they serve.
 
Medicaid Long-Term Care Application Support Specialist
 100% Remote (Requires regional travel within the state of New Hampshire)
 
Overview: 
The Regional Mobile Medicaid Application Support Specialist assists individuals across New Hampshire in understanding and completing Medicaid Long-Term Care (LTC) financial eligibility determinations and redeterminations. This role provides hands-on application support and education to individuals, families, providers, and administrators at nursing homes, assisted living facilities, hospitals, and other designated locations—primarily within Hillsborough, Rockingham, Cheshire, Grafton, or Merrimack counties.
 Incumbents serve as key points of contact for applicants and their families, helping improve understanding of eligibility requirements and increasing timely and complete application submissions, and supporting Facility administrative staff with
 
Key Responsibilities: 
<ul>
<li>Travel to assigned on-site locations throughout New Hampshire to support nursing home staff in and to meet with residents and families to provide hands on assistance.</li>
<li>Review pending applications assigned by the LTC Eligibility Supervisor or Nursing Facility Point of Contact for completion and compliance with state and federal requirements</li>
<li>Clearly explain complex requirements to individuals, families, and authorized representatives and assist them in completing applications during scheduled in-person or virtual appointments.</li>
<li>Guide applicants through required forms, gathering acceptable documentation, and submitting electronic and physical applications.</li>
<li>Educate applicants on Medicaid LTC financial rules, including spend down, asset transfers, spousal impoverishment, and third party liability.</li>
<li>Review submitted documentation, identify missing verifications, and support applicants with gathering missing items.</li>
<li>Provide updates to the Eligibility Supervisor and Project Management team regarding assistance provided and any process barriers encountered.</li>
<li>Uphold all State, Federal, and PCG confidentiality and security protocols.</li>
<li>Other duties as assigned.</li>
</ul>
Skills & Knowledge:Successful candidates will demonstrate: 
<ul>
<li>Ability to work independently in a remote environment with minimal in-person supervision.</li>
<li>Proficiency with Microsoft Teams, Outlook, Word, and Excel.</li>
<li>Ability to quickly learn and apply New Hampshire Medicaid LTC financial eligibility criteria to unique cases.</li>
<li>Strong communication skills, with the ability to explain processes and requirements to individuals with diverse communication and functional needs.</li>
<li>Strong customer service orientation.</li>
<li>Excellent organizational, documentation, and problem-solving skills.</li>
<li>Sensitivity and professionalism when working with diverse populations.</li>
<li>Familiarity with Federal and New Hampshire Medicaid eligibility processes. Experience with Long Term Care Eligibility requirements preferred.</li>
</ul>
Minimum Qualifications
 <ul>
<li>Bachelor’s degree in social work, human services, business administration, or a related field; OR equivalent experience.</li>
<li>1–3 years of experience supporting individuals in long-term care, community health, case management, or related settings.</li>
<li>Ability to read, write, and speak English clearly.</li>
<li>Successful completion of a background check.</li>
<li>Private, distraction free workspace with reliable high speed internet.</li>
<li>Reliable transportation for daily travel to locations across New Hampshire.</li>
</ul>
Location & Schedule: 
This is a salaried, field based role requiring daily travel to on-site locations across New Hampshire.
 Work schedule: Monday–Friday, 8:00am – 4:30pm ET
 
Compensation
 Salary: $50,000 annually.
 
Benefits
 At SSO, we invest in your health, financial security, and professional growth. Benefits include:
 <ul>
<li>Medical, vision, and dental insurance</li>
<li>401(k) with discretionary employer match</li>
<li>Paid time off and holidays</li>
<li>Flexible spending accounts</li>
<li>Additional employee perks</li>
</ul>
Keyword Search Terms
 Medicaid • Long-Term Care • LTC • Application Support • Eligibility Specialist • Medicaid Eligibility • Human Services • Social Services • Case Management • Community Health • Assisted Living • Nursing Home Support • Financial Eligibility • Medicaid Redetermination • Field-Based Specialist • Onsite Support • New Hampshire Medicaid • BFA-800 • Applicant Assistance • Public Health Services • Customer Service • Documentation Review • Outreach Specialist • Mobile Specialist • Healthcare Access • Medicaid Program Support
 
Compensation for roles at Staffing Solutions Organization LLC (SSO) varies depending on a wide array of factors including, but not limited to, the specific office location, role, skill set, and level of experience. As required by applicable law, SSO provides a reasonable range of compensation for this role. In addition, SSO provides a range of benefits for this role.
 
Applicants must be authorized to work in the U.S. This position is not eligible for work authorization sponsorship (including H-1B sponsorship) by SSO and under the federal laws relating to the F-1 STEM EAD program, this position is not eligible to support a STEM EAD extension application.
 
All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, marital status, age, national origin, protected veteran status, or disability. Staffing Solutions Organization LLC is an E-Verify participant.

Medicaid LTC Application Support Specialist - NH

Integrity Management Services, Inc.

<div>About Us
Integrity Management Services, Inc. (IntegrityM) is an award-winning, women-owned small business specializing in assisting government and commercial clients in compliance and program integrity efforts, including the prevention and detection of fraud, waste and abuse in government programs. Results are achieved through data analytics, technology solutions, audit, investigation, and medical review.
At IntegrityM, we offer a culture of opportunity, recognition, collaboration, and supporting our community. We thrive off of these fundamental elements that make IntegrityM a great place to work. Our small, flexible workplace offers an exceptional quality of life and promotes corporate-driven sustainability. We deliver creative solutions that exceed goals and foster a dynamic, idea-driven environment that nurtures our employees&rsquo; professional development. Large company perks&hellip;Small company feel!
www.integritym.com
In this role, the Medicaid Audit and Compliance Specialist will be responsible for performing and reporting on Medicaid Managed Care Plans and providers to identify potential fraud, waste, and abuse; issue findings and recommendations; and identify improper payments. Audit assignments can be programmatic or financial and may range from desk reviews and/or onsite review activities as determined by federal and state regulations. Specific review types may include case management, program payment appropriateness, program and policy compliance, billing, coding and medical record documentation reviews, as well as research and analysis of industry trends. The Medicaid Audit and Compliance Specialist will perform audits as assigned which consist of but are not limited to performing licensing and exclusion reviews on providers and work with the medical staff to ensure services are reimbursed meet regulatory requirements. The Medicaid Audit and Compliance Specialist will work independently as well as collaboratively with other audit staff. 
Job Responsibilities: 
<ul><li>
Applies in-depth knowledge of federal and state regulations and healthcare industry standards.</li></ul> 
<ul><li>
Comprehends and follows auditing plans and methodologies specific to contract requirements.</li></ul> 
<ul><li>Prioritization and assignment of workload, ensuring adherence to task order policies and procedures.</li></ul> 
<ul><li>
Examines and calculates data from financial documents and statements such as provider cost reports as a method of audit.</li></ul> 
<ul><li>
Utilize data mining and trend analysis tools to detect anomalies in Medicaid billing and payment patterns.</li></ul> 
<ul><li>
Attend on-site audits to retrieve medical records and conduct provider entrance/exit conference.</li></ul> 
<ul><li>
Prepare and submit medical record request letters to providers associated with requests for medical record requests or suspension overpayment determinations.</li></ul> 
<ul><li>
Interpret and apply pertinent laws, regulations, policies, and procedures relevant to the specific audit findings and provider type being audited.</li></ul> 
<ul><li>
Ensure Generally Accepted Government Auditing Standards (GAGAS) standards are applied to each applicable audit to identify fraud, waste or abuse.</li></ul> 
<ul><li>
Preparing factual and objective written reports in conformance with professional auditing and evaluation standards and present findings to leadership, external agencies, and government partners.</li></ul> 
<ul><li>
Calculates improper payments, and issues findings, recommendations, and corrective actions in accordance with applicable regulations, policies and procedures.</li></ul> 
<ul><li>Prepare and send suspension overpayment determinations to providers when applicable.</li></ul> 
<ul><li>
Communicates with federal/state agencies and providers regarding issues such as general regulatory compliance, audit findings, and the recovery process.</li></ul> 
<ul><li>
Attends briefings and presentations as assigned.</li></ul> 
<ul><li>
Maintains fraud case development quality standards so that proper case development is ensured, and quality cases are fully prepared.</li></ul> 
<ul><li>Maintains proper and timely updates in appropriate tools and applications for their investigations. Case development databases and documents.</li></ul> 
<ul><li>
Develops and documents reports of investigative findings, compiles case file documentation, calculates improper payments, and issues findings, recommendations, and corrective actions in accordance with applicable regulations, policies and procedures.</li></ul> 
<ul><li>Program research relating to federal program applications, eligibility, payments, and other program requirements.</li></ul> 
<ul><li>
Conducts on-site visits and/or interviews as required for investigation.</li></ul> 
<ul><li>Identify weaknesses in current audit processes and recommend enhancements for improved efficiency and effectiveness.</li></ul> 

Performs ad hoc tasks/duties as assigned. 
<ul><li>
</li></ul> 
 
Requirements 
<ul><li>
Bachelor&rsquo;s Degree in finance, accounting or related field required.</li><li>
5-7 Years of related experience in finance, accounting, or auditing.</li><li>
Intermediate knowledge of internal audit policies and operating principles.</li><li>
Intermediate knowledge and experience in auditing Medicare/Medicaid and other government payment and oversight programs. (CMS, HRSA, OIG, DOE, Dept. of Commerce etc.)</li><li>
Knowledge and experience in the application of government accounting principles and standards, including Generally Accepted Government Auditing Standards (GAGAS).</li><li>
Experienced investigative skills.</li><li>
Strong data analysis skills.</li><li>
Knowledge of medical terminology, ICD-9-CM, ICD-10-CM HCPCS level II and CPT codes. Utilizes Medicaid and Contractor guidelines for coverage determinations.</li><li>
Experience in reviewing claims for appropriate billing and medical coding requirements, performing medical review, and/or developing fraud cases.</li><li>
Strong oral and written communication skills, strong interpersonal skills, and superior organizational abilities.</li><li>
Ability to take initiative, to maintain confidentiality, to meet deadlines, and to work in a team environment.</li><li>
Ability to report work activity on a timely basis.</li><li>
Ability to work independently and as a member of a team to deliver high quality work.</li><li>
Ability to multitask and prioritize assignments while meeting deadlines.</li><li>
Proficiency in Microsoft Office, specifically Microsoft Word and Excel.</li><li>
Passion and alignment with IntegrityM&rsquo;s mission, vision, values and operating principles.</li></ul>
Additional Requirements:<ul><li>
Must pass post hire background screening checks.</li><li>
For remote work, required to have wired and/or wireless internet access.</li></ul></div>

Medicaid Audit and Compliance Specialist (Full-time, Remote)

Jackson County, NC

<div><div><div><h2 class="jobSectionHeader">Position Overview</h2></div>
<div>The primary purpose of this position is to determine eligibility for Medicaid programs which includes intake, processing, and maintenance of cases in the Family and Children's Medicaid unit. Grade 17 - 19. 
 
Starting Salary Range: $33,173.05 - $36,573.28 depending upon education and experience. Will accept &quot;work-against&quot; applications.</div>
<div><h2 class="jobSectionHeader">Duties and Responsibilities</h2></div>
<div>Work Schedule - 8:00 AM to 5:00 PM, 40 hours a week Monday through Friday. Some after-hours work is required on occasion. 
<ul><li>
Conduct interviews during intake to assess needs and obtain information.</li><li>
Inform Medicaid applicant of their rights, appeal decisions, ability to withdraw application, right to re-apply if found ineligible, responsibilities of the agency.</li><li>
Complete recertifications and changes in accordance with provided guidance, regulations, and policies.</li><li>
Utilize the NCFAST computer system</li><li>
Adhere to established deadlines.</li><li>
Complete paperwork as mandated by the agency or county administration.</li><li>
Attend various training workshops/webinars.</li><li>
Perform other duties as assigned by the supervisor.</li></ul></div>
<div><h2 class="jobSectionHeader">Education and Experience</h2></div>
<div>Graduation from high school and one year of experience as an Income Maintenance Caseworker; or an equivalent combination of training and experience. Will accept &quot;work-against&quot; applications.</div>
<div><h2 class="jobSectionHeader">Knowledge, Skills and Abilities</h2></div>
<div><ul><li>Ability to read and comprehend rules and regulations, often changing policies and guidelines pertaining to Medicaid assistance programs.</li><li>
Ability to interpret agency's policies and procedures to people of varied backgrounds.</li><li>
Ability to accurately key codes and data into NCFAST.</li><li>
Obtain data for documentation and verification of information needed in determining eligibility.</li><li>
Detect need for other agency services and make appropriate referrals to the service staff.</li><li>
Work with facts and figures and perform tasks involving a high degree of accuracy.</li><li>
Learn the intricacies of numerous forms and procedures of the eligibility programs.</li><li>
Present information orally or in report form.</li><li>
Acquire interest in and understanding of disadvantaged persons.</li><li>
Possess qualities of patience and tolerance, and an awareness of various cultures.</li><li>
Must have ability to effectively communicate face- to- face and on the telephone.</li></ul></div></div></div>
 <div></div><div><div><div>Jackson County provides a robust offering of employee benefits including: employer paid medical and dental benefits, participation in the Local Governmental Employees&rsquo; Retirement System, paid leave (vacation, sick, and holiday), Employee Clinic, Wellness program, and supplemental benefit offerings.</div></div></div>

Income Maintenance Caseworker II (Family and Children's Medicaid)

Savista

<div>Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE).
Job Purpose 
The Eligibility Specialist I is a critical advocate for patients, helping uninsured and underinsured individuals access financial assistance for medical care. This role involves conducting detailed assessments, guiding patients through application processes for government and charity-funded programs and ensuring compliance with healthcare regulations. Successful candidates are empathetic, detail-oriented, and skilled at navigating healthcare systems to support patients in receiving the care they need.
Work Schedule and Location:
<ul><li>Work Hours: Full time, 40 hours per week, hourly position. Flexibility required, with shifts available between the days and hours of Monday through Saturday from 8:00am to 6:00pm to meet business needs.</li><li>
Primary Locations: This position is onsite and will be required to service the primary hospital locations of:<ul><li><h2 class="jobSectionHeader">
HonorHealth Scottsdale Osborn Medical Center: 7400 E Osborn Rd Scottsdale, AZ 85251</h2></li></ul></li></ul>
Key Responsibilities<ul><li>
Meet with patients in-person, including bedside visits, to assess financial assistance eligibility and provide compassionate guidance on available programs.</li><li>
Facilitate the application process for programs such as Medicaid, Medicare, Disability, and hospital charity care, ensuring timely submission of accurate documentation.</li><li>
Act as a liaison between patients, hospital staff, and government agencies to establish eligibility, secure funding and resolve coverage issues.</li><li>
Manage multiple patient cases, prioritizing tasks to meet deadlines and ensure effective follow-up on pending applications.</li><li>
Clearly communicate financial obligations, funding options, and program details to patients in an empathetic and professional manner.</li><li>
Maintain accurate and confidential records in compliance with HIPAA and organizational policies.</li><li>
Consistently achieve productivity and quality metrics, contributing to the organization's financial counseling objectives.</li><li>
Efficiently use multiple systems and databases to gather, track, and report on patient data.</li><li>
Assist with vacancy coverage, as needed.</li><li>
Complete special projects, as assigned.</li></ul>
Qualifications &amp; Competencies:
Required:<ul><li>
High school diploma or GED</li><li>
At least 1 year of experience in a customer-facing role, preferably in healthcare or financial counseling.</li><li>
Flexibility to provide support at nearby hospital locations within assigned market area, as needed for vacancy coverage.</li><li>
Strong organizational skills with the ability to handle multiple priorities and maintain accuracy and attention to detail.</li><li>
Excellent verbal and written communication skills, with the ability to explain complex information clearly and empathetically.</li><li>
Ability to identify solutions to financial challenges, leveraging program knowledge to benefit patients.</li><li>
Capability to work in a fast-paced environment with changing priorities and patient needs.</li><li>
Demonstrate genuine care for patients&rsquo; needs and concerns, building trust and rapport.</li><li>
Work effectively with colleagues, hospital staff, and external agencies to achieve shared goals.</li><li>
Ensure all documentation is accurate, complete, and submitted on time.</li></ul>
Preferred:<ul><li>
Experience in healthcare revenue cycle, financial counseling, or insurance verification.</li><li>
Basic knowledge of state and federal assistance programs such as Medicaid, Medicare, and Social Security Disability.</li><li>
Knowledge of medical terminology and healthcare accounts receivable processes.</li></ul>
Savista is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. The salary range for this role is from $19 to $21 per hour. However, specific compensation for the role will vary within the above range based on many factors including but not limited to geographic location, candidate experience, applicable certifications, and skills.
SAVISTA is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity or any other federal, state or local protected class.
California Job Candidate Notice</div>

Eligibility Specialist 1

Granville County

Position SummaryResponsible for administering income maintenance programs by applying comprehensive knowledge of policies, regulations, and community resources to support client eligibility and services. Interprets complex guidelines, performs accurate calculations, and manages caseloads within established timeframes. Works independently to prioritize tasks while maintaining high standards of accuracy and compliance. Provides guidance, training, and oversight to staff, and effectively communicates with clients to understand their needs and connect them with appropriate services.Knowledge and Skills <ul><li>Ability to interpret and apply complex rules, regulations, and policies accurately.</li><li>Strong knowledge of income maintenance programs, along with a solid understanding of related agency and community services.</li><li>Good mathematical and problem-solving skills for handling calculations and case details.</li><li>Strong organizational skills, with the ability to work independently and manage priorities effectively.</li><li>Leadership abilities, including supervising, training, and evaluating staff.</li><li>Good communication and interpersonal skills to understand and support clients&rsquo; needs.</li><li>Ability to manage caseloads efficiently while meeting structured deadlines and timeframes.</li></ul>Qualifications<ul><li>Two (2) years of experience as an Income Maintenance Caseworker; or an equivalent combination of training and experience.</li><li>Must have a valid driver&rsquo;s license.</li><li>Three (3) years of experience determining eligibility for State or County Department of Social Services program (Medicaid, Food and Nutrition Services, Work First, Childcare Subsidy, Child Support, or Energy Assistance Program).</li><li>Two (2) years of program specific experience (Adult Medicaid Program)</li></ul>*Please note, this is only a summary. The full job description is available upon request*Pay: $46,435.00 - $75,759.00 per yearBenefits:<ul><li>401(k) matching</li><li>Dental insurance</li><li>Health insurance</li><li>Retirement plan</li><li>Vision insurance</li></ul>Work Location: In person

Income Maintenance Caseworker III - Adult Medicaid

Community Action Committee of Pike County

<div>The Eligibility Enrollment Specialist &ndash; Housing provides front-end client support and eligibility determination for housing and utility assistance programs within the Community Services Department. This role conducts intake, processes applications, maintains client records, and ensures clients are connected to the most beneficial programs available.

The Eligibility Enrollment Specialist works closely with clients, landlords, utility vendors, and internal staff to streamline the enrollment process, reduce delays, and improve overall service delivery. This position plays a critical role in supporting Housing Case Managers by managing intake and eligibility functions while maintaining compliance, confidentiality, and accuracy.

<h1 class="jobSectionHeader">Enrollment &amp; Eligibility Coordination</h1>

Estimated Effort: 60%
<ul><li>
Answer client questions through:
<ul><li>Phone calls</li><li>
Emails</li><li>
Walk-ins</li></ul>
</li><li>Accept and process new client applications through:
<ul><li>In-person submissions</li><li>
Email</li><li>
Fax</li><li>
Document drop-offs</li></ul>
</li><li>Create and maintain digital client files based on received documentation.</li><li>
Screen client files using program checklists and notify clients of missing documentation promptly.</li><li>
Maintain detailed progress notes for each client interaction.</li><li>
Assist clients with applications across Community Services programs, including:
<ul><li>Homeless Crisis Response Program (HCRP)</li><li>
Homeless Prevention (HP)</li><li>
Utility Assistance Plus (UAP)</li><li>
Home Energy Assistance Program (HEAP)</li><li>
Emergency HEAP (E-HEAP)</li><li>
Percentage of Income Payment Plan (PIPP)</li><li>
Rapid Re-Housing (RRH)</li><li>
Neighbor to Neighbor (N2N)</li><li>
CAC Crisis Fund</li></ul>
</li><li>Compare available programs and determine which provides the greatest benefit to the client.</li><li>
Maintain strict confidentiality of all client information.</li><li>
Perform general administrative duties including:
<ul><li>Answering phones</li><li>
Typing</li><li>
Filing</li></ul>
</li></ul><h1 class="jobSectionHeader">Customer Service &amp; Client Support</h1>

Estimated Effort: 30%
<ul><li>
Conduct client interviews (in-person and digital) to determine eligibility for housing assistance programs.</li><li>
Establish and maintain organized digital client files.</li><li>
Serve as a liaison between:
<ul><li>Clients</li><li>
Landlords</li><li>
Utility vendors</li><li>
Community partners</li></ul>
</li><li>Maintain a high standard of professionalism and customer service.</li><li>
Collaborate with staff and partners to ensure compliance with program guidelines.</li><li>
Refer clients to other CAC programs or community resources as appropriate.</li><li>
Develop knowledge of available community resources and assistance programs.</li></ul>
<h1 class="jobSectionHeader">Service &amp; Program Support</h1>

Estimated Effort: 10%
<ul><li>
Provide direct support to Housing Case Managers.</li><li>
Work independently with minimal supervision.</li><li>
Stay informed on new and existing assistance programs within the community.</li><li>
Attend trainings, meetings, and conferences related to housing and eligibility services.</li><li>
Share relevant information with internal and external stakeholders.</li><li>
Adhere to all agency safety policies and procedures.</li><li>
Perform all other duties as assigned.</li></ul>
<h1 class="jobSectionHeader">Minimum Requirements</h1>

Education
<ul><li>
High School Diploma or equivalent.</li></ul>

Job-Related Experience
<ul><li>
Minimum of two (2) years of clerical or office experience.</li><li>
Experience using basic computer applications, including:
<ul><li>Microsoft Word</li><li>
Outlook</li><li>
Excel</li></ul>
</li></ul><h1 class="jobSectionHeader">Licenses, Certifications, and Accreditations</h1>
<ul><li>Valid Ohio Driver&rsquo;s License.</li><li>
Proof of insurance.</li><li>
Must be insurable under agency policy.</li></ul>
<h1 class="jobSectionHeader">Preferred Qualifications</h1>
<ul><li>Experience with housing programs and eligibility systems such as:
<ul><li>Ohio Community &amp; Energy Assistance Network (OCEAN)</li></ul>
</li><li>Experience with HMIS data entry.</li><li>
Background in housing, social services, or community assistance programs.</li></ul>
<h1 class="jobSectionHeader">Working Conditions</h1>
<ul><li>Work is performed in a standard office environment.</li><li>
Fast-paced setting with multiple competing priorities.</li><li>
Requires strong organization and attention to detail.</li><li>
Housing program guidelines and funding sources change frequently.</li><li>
Position may involve moderate to high levels of stress.</li></ul></div>

Housing Eligibility Enrollment Specialist

Companion Home Care

Company OverviewCompanion Home Care is committed to enabling individuals to live life to the fullest in the comfort of their own homes. We provide compassionate and personalized care that promotes physical well-being, emotional stability, and self-determination. Our approach is rooted in understanding and compassion, as we strive to become part of your family.SummaryWe are seeking a Billing Specialist to join our team at Companion Home Care. This role is responsible for various duties related to authorizations, billing claims, posting payments, and collecting accounts receivable. Our team's goal is to reduce the organization's accounts receivable by keeping detailed accounting systems through our internal system. In this role, you will play a vital part in managing billing processes and ensuring accurate financial transactions related to our home care services and durable medical equipment transactions. Your work will contribute significantly to our mission of providing exceptional care while maintaining the dignity and respect our clients deserve.Responsibilities<ul><li>Create batch billing from time records and create all invoices for the clients as needed.</li><li>Submit and ensure all client&rsquo;s electronic billing is processed according to payer timely filing guidelines as needed.</li><li>Resolve all claim denials per the mandatory process.</li><li>Contact payer by phone, email, fax, or support ticket to resolve denials for client.</li><li>Review accounts receivable to identify posting or billing issues and resolve these issues.</li><li>Liaison between clients, payers, and office staff.</li><li>Post electronic and manual payments to accounts within mandatory process.</li><li>Process billing for services rendered, ensuring accuracy and compliance with regulations.</li><li>Maintain detailed records of billing transactions and client accounts.</li><li>Communicate with clients regarding billing inquiries and resolve any discrepancies.</li><li>Collaborate with healthcare providers to obtain necessary documentation for billing purposes.</li><li>Stay updated on changes in medical coding and billing regulations, including ICD-10 and ICD-9 codes.</li><li>Assist in the preparation of financial reports related to billing activities.</li></ul>*Requirements<ul><li>4+ years of experience in claims handling, healthcare billing, accounts receivable, aging reports, and/or posting payments.</li><li>Must have healthcare claims experience.</li><li>Must have excellent customer service skills.</li><li>Ability to work independently.</li><li>Strong attention to detail and high level of accuracy.</li><li>Ability to prioritize workload and maintain an organized system for processes.</li><li>Excellent written and verbal communication skills.</li><li>Proficiency in Microsoft Office products, including Outlook, Excel, and SharePoint.</li><li>Proven experience in personal care or general medical billing.</li><li>Familiarity with NC LME/MCOs and Tailored Plan billing processes.</li><li>Understanding of IDD terminology and NC Medicaid service definitions.</li><li>Strong knowledge of medical terminology and coding practices, including ICD-10.</li></ul>We invite you to apply today and become part of our dedicated team at Companion Home Care!Job Type: Full-timePay: $23.00 - $26.00 per hourBenefits:<ul><li>401(k)</li><li>Dental insurance</li><li>Disability insurance</li><li>Life insurance</li><li>Paid time off</li><li>Vision insurance</li></ul>Work Location: In person

Medicaid Billing Specialist

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