Medicaid/Medicare Consultant

Medicaid/Medicare Consultant

Enjoy problem-solving, need a venue to display your creativity, and emerging technologies pique your interest; if so, Barrow Wise Consulting, LLC is for you. As a multi-disciplined leader, you understand the gifts that set you apart from everyone else. Demonstrate innovative solutions to our clients. Join Barrow Wise Consulting, LLC today.

Responsibilities:

The Medicaid/Medicare Consultant will support Barrow Wise's Illinois DHS project and perform the following duties:

• Serves as the Medicare/Medicaid consulting expert
• Provide and manage consulting, data transfer, and claims processing services to increase federal revenues in Medicare A, B, D, and Medicaid in IDHS State Operated Facilities
• Provide revenue maximization services for Medicare A, B, D, and Medicaid
• Enhance billing and coding accuracy, claims management, eligibility verifications, regulations, and compliance with recommendations and implementation of training, new systems, processes, and automation
• Provide and manage services to process Medicare D claims and collection as required by Federal Medicare D rules and requirements; ensure a streamlined and compliant billing and collection function, including an electronic accounts receivable system specific to pharmacy claiming
• Review and assess the current Medicare Part A & B, Medicaid, claiming policies, procedures, practices, and outcomes of each State-operated facility for mental health and developmental disabilities
• Assist the State with billing Medicare Part A & B and Medicaid programs; provide IDHS with detailed information identifying those claims that the vendor submitted in an agreed-upon format and frequency
• Assist the State in the completion of annual Medicare cost reports by reviewing Medicare cost report schedules to ensure reports are completed appropriately and maximize Medicare and Medicaid cost reimbursement
• Implement processes to improve billing and claiming with the transition to State staff
• Provide recommendations as to the level and expertise necessary for individuals to conduct billing and claim to achieve optimal revenue
• Develop and deliver training, documents, manuals, and other resources required to promptly identify and correctly bill for eligible individuals served by the DHS State-Operated Facility programs
• Work as a mediator between the State and the Fiscal Intermediary NGS (National Government Services), which requires them to answer questions related to the Medicare cost reports, billings and claims
• Assist the IDHS Office of Fiscal Services with the submission of Medicare bad debt claiming
• Assist the IDHS Office of Fiscal Services with the submission of annual Medicare cost reports
• Identify additional revenue maximization opportunities for IDHS
• Develop project reports and present data to the State

An ideal candidate has the following:

• U.S. Citizenship
• Bachelor's degree
• 10 years of experience with Medicare and Medicaid claims processing systems and revenue maximization services
• Knowledge of automation in healthcare claims
• Proficient in Project Management and Business Analysis practices, principles, and tools
• Excellent written and verbal communication skills

Join the team at Barrow Wise Consulting, LLC, for a fulfilling and engaging experience! Our team is dedicated to providing innovative solutions to our clients in an ethical and diverse work environment. We offer competitive compensation packages, excellent benefits, and opportunities for growth and advancement. Barrow Wise is an equal-opportunity, drug-free employer committed to diversity in the workplace. Minority/Female/Disabled/Protected Veteran/LBGT are welcome to apply.

Our employees stand behind Barrow Wise's core values of integrity, quality, innovation, and diversity. We are confident that Barrow Wise's core values, business model, and team focus create positive career paths for our employees. Barrow Wise will continue to lead the industry in delivering new solutions to clients and persevere until the client is overjoyed.