Managed Medicaid Specialist

SUMMARY The Medicaid managed Care Specialist works to review, investigate and follow-up on various insurance claims. ESSENTIAL DUTIES AND RESPONSIBILITIES Ensure that established accounting procedures are followed for processing insurance claims Checking for accuracy of information for claim submission. Monitoring claims processing status, recorded payments and adjustments within the billing system. Maintain accurate records, up to date billing systems Managing and submitting appeals, calls, emails and other efforts to obtain insurance coverage payment. Follow-up on, collect and allocate payments as applicable Performing collections follow-up process in accordance with established procedures. Research and Resolve denied claims in a timely fashion Investigate and resolve customer queries and communicate with customers via phone, email, mail or personally Assist with preparation of monthly statements, or as requested by supervisor Other duties as assigned QUALIFICATIONS Experience in Long Term Care industry, preferred Experienced in Managed Medicaid billing Experience in Point Click Care (PCC) billing system is preferred PHYSICAL DEMANDS Must be able to move intermittently throughout the workday. #J-18808-Ljbffr