| We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law. |
MedData has an excellent career opportunity available as a Senior Claims Specialist. The schedule for this Full Time role is Monday through Friday 8 AM to 5 PM. This is a remote based role.
MedData provides revenue cycle solutions to hospitals and physicians throughout the United States. This includes AR support for Out-of-State Medicaid accounts. The purpose of this position is conduct Medicaid eligibility, authorization, enrollment and payment posting functions.
ESSENTIAL DUTIES AND 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.
QUALIFICATIONS AND REQUIREMENTS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or abilities.
- 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.
The job description does not constitute an employment agreement between the employer and Employee and is subject to change by the employer as the needs of the employer and requirements of the job change. This job description is to serve as a guide but no way is it to be considered a comprehensive list of task, duties and responsibilities that will be required by the employee.
To join our team of 2,000 employees and growing, please apply directly to this posting.
MedData is an Equal Opportunity Employer
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