Elevate Patient Financial Solutions® · 1 day ago
Senior OOS Medicaid Claims Specialist
United States
Full-time
Remote
Mid, Senior Level
$19/hr - $26/hr
2+ years expElevate Patient Financial Solutions has an exciting career opportunity available as a Senior OOS Medicaid Claims Specialist. The purpose of this position is to conduct Medicaid eligibility, authorization, enrollment, and payment posting functions. This role involves confirming eligibility, submitting authorization requests, and providing strong customer service to clients.
Business IntelligenceHealth CareInformation Technology
Responsibilities
Confirm eligibility and authorization requirements for Medicaid patients
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
Gather and maintain credentials from hospitals and physicians
Coordinate with hospitals and physicians to accurately complete Medicaid enrollment applications
Submit hospital and physician enrollment applications to Medicaid payers and complete timely follow up to ensure applications process correctly
Manage and comply with client and Medicaid enrollment guidelines
Update enrollment status, documentation, and information in software system
Provide strong customer service to clients and provide responses to client inquiries within 24 hours
Research and obtain necessary documentation to post unapplied cash
Complete payment reconciliation reports on a weekly or monthly basis
Review Medicaid payments for accuracy and submit payment information to the cash posting team
Facilitate timely payment from Medicaid payers
Work in compliance with state and federal guidelines, including HIPAA and FDCPA
Maintain case clear, concise, and accurate account notation
Monitor status of each account and communicate effectively with management, clients, and other parties regarding the status of the accounts
Other duties as assigned
Qualification
Required
High School Diploma or GED
Working knowledge of ICD9, CPT codes, HIPAA, HCPCS and Medicaid preferred
2-3 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
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 StageTotal Funding
unknown2025-08-04Private Equity
Leadership Team
Michael Shea
Chairman & Chief Executive Officer
Recent News
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