Medicaid Billing Specialist
Job description
Purpose: The primary responsibility of this position will be to check Medicaid websites for Medicaid coverage on our clients and update our EMR paying close attention to clients with Spenddown. Medicaid spenddown clients must be checked frequently to identify if a spenddown is met or if a client is in a new spenddown period. This will be a priority to ensure revenue is booked and billed correctly.
Accountabilities:
- Check multiple Medicaid websites for client eligibility and enter information into EMR daily.
- Work with electronic files on Medicaid websites.
- Maintain separate tracking of Medicaid spenddown clients on a spreadsheet as well as where the client is periodically with their spenddown.
- Ensure that the correct billing pay source is assigned to any client who has a current spenddown.
- Responsible to ensure that a client is moved to their MCO pay source when their spenddown is satisfied.
- Responsible to track and record volume and data on spreadsheets for weekly submission to manager.
- Responsible to rebill previously unbilled services to Medicaid if/when retro eligibility is established.
- Responsible to make billing adjustments as necessary on Medicaid client accounts.
- Responsible to professionally communicate information on clients Medicaid eligibility times to various parties/departments to facilitate continuous eligibility.
- Responsible for high level of accuracy in daily work completed.
- Assist with other reimbursement related functions as time allows.
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