Elevate Patient Financial Solutions® · 1 day ago
OOS Medicaid Claims Specialist
United States
Full-time
Remote
Entry Level
1+ years exp
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Responsibilities
Properly identify Medicaid eligibility, authorization, enrollment and documentation requirements for hospital and physician accounts. Training and software to assist with these functions will be provided.
Submit authorization requests to Medicaid payers and perform appropriate follow up to ensure authorization requests are resolved in a timely manner.
Perform manual data entry of patient accounts and or claim forms.
Obtain bills, medical records or other necessary documentation from medical providers in a timely manner.
Review and edit claims to ensure they meet state and federal guidelines.
Submit claims timely and accurately to Medicaid payers.
Perform aggressive follow-up on unresolved claims.
Facilitate timely payment from Medicaid payers.
Research denials and/or underpayments and formulate appeal letters and/or disputes to Medicaid plans in accordance with state guidelines.
Submit payment details to the cash posting team.
Work in compliance with state and federal guidelines, including HIPAA and FDCPA.
Maintain case clear, concise and accurate account notation.
Monitor the status of accounts and communicate effectively with management, clients and other parties regarding the status of the accounts.
Provide responses to client inquiries within 24 hours.
Other duties as assigned.
Qualification
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Required
High School Diploma or GED.
1-2 years of related experience in the healthcare industry or in a related area.
Excellent verbal and written communication skills.
Strong organizational skills.
Ability to multi-task.
Critical thinking and strong attention to detail.
Required computer skills: must have experience with data entry and word processing, be capable of operating routine office equipment, possess a working knowledge of MS Office applications, and understand how to navigate through multiple web-based applications.
Remote and Hybrid positions require a home internet connection that meets the company’s upload and download speed criteria.
Preferred
Working knowledge of ICD9, CPT codes, HIPAA, HCPCS and Medicaid preferred.
Benefits
Medical, Dental & Vision Insurance
401K (100% match for the first 3% & 50% match for the next 2%)
15 days of PTO
7 paid Holidays
2 Floating holidays
1 Elevate Day (floating holiday)
Pet Insurance
Employee referral bonus program
Teamwork: We believe in teamwork and having fun together
Career Growth: Gain great experience to promote to higher roles
Company
Elevate Patient Financial Solutions®
Elevate Patient Financial Solutions® is a trusted partner who delivers superior RCM solutions to hospitals, health systems, and health providers nationwide.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
Michael Shea
Chairman and Chief Executive Officer
Recent News
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