Health Information Specialist: EHR & Medicaid Billing

Four County Health and Rehabilitation; Tyrone (GA); On-site; USD 52,000 - 76,000; Full time

Job summary

NextStep Care seeks a dedicated care management data specialist to support eligibility, documentation and data integrity across Medicaid, Medicare and private pay portfolios. You will maintain EHR records, process LOC approvals, and coordinate with operations and the quality team to ensure timely submissions and accurate billing information.

The role emphasizes attention to detail, strong organizational skills, and proficient use of EHRs and Microsoft Office in a fast-paced healthcare setting.

Qualifications

• High School Diploma or equivalent.
• Three years of experience in healthcare with Medicaid or case management preferred.
• Valid Driver's License.
• Proficiency with Microsoft Outlook, Excel and Word.

Responsibilities

• Maintains accurate member records in electronic health record (LOC), including submission dates and status.
• Retrieves daily LOC approvals/denials from GAMMIS and updates tracking tools.
• Communicates with operations, assessment, and external stakeholders regarding approvals/denials.
• Knowledge of Medicare, Medicaid, Private Pay, and third-party reimbursement.
• Maintains information in software tracking tools regarding transmission of patient data.
• Verifies assessments are reviewed, submitted, and tracked in internal systems.

Skills

Customer service

Organization

Communication skills

Computer skills

Education

High School Diploma or equivalent

Tools

EHR systems

Smart Sheet

Job description

NextStep Care seeks a dedicated care management data specialist to support eligibility, documentation and data integrity across Medicaid, Medicare and private pay portfolios. You will maintain EHR records, process LOC approvals, and coordinate with operations and the quality team to ensure timely submissions and accurate billing information.

The role emphasizes attention to detail, strong organizational skills, and proficient use of EHRs and Microsoft Office in a fast-paced healthcare setting.