Managed Medicaid Specialist

Curis Services; Lincolnwood (IL); On-site; USD 40,000 - 60,000; Full time

Job summary

Curis Services in Lincolnwood, IL is seeking a Medicaid Managed Care Specialist to review and follow up on insurance claims, ensuring accuracy and timely processing.

You will handle appeals, monitor payments, maintain billing records, respond to inquiries by phone or email, and support monthly statement preparation, with a focus on efficient resolution of denied claims and payer communications. Previous experience in long-term care and Medicaid billing is preferred.

Qualifications

• Experience in Long Term Care industry.
• Experience in Managed Medicaid billing.
• Experience with the PCC billing system (Point Click Care).

Responsibilities

• Process insurance claims following established procedures.
• Verify accuracy of claim submission information.
• Monitor claims status, payments and adjustments in the billing system.
• Maintain accurate billing records and up-to-date systems.
• Submit appeals and communicate with payers via phone, email, or mail.
• Follow up to collect and allocate payments.
• Perform collections follow-up per procedures.
• Research and resolve denied claims promptly.
• Address customer questions via phone, email, or in person.
• Assist with monthly statements as requested.

Skills

Long Term Care

Managed Medicaid billing

PCC billing system

Job description

Medicaid Managed Care 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

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements below are representative of the knowledge, skill, and/or ability required.

• Experience in Long Term Care industry, preferred
• Experienced in Managed Medicaid billing
• Experience in Point Click Care (PCC) billing system is preferred

PHYSICAL DEMANDS

The physical demands are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Must be able to move intermittently throughout the workday.