Medicaid Biller

Pennant; Utah; On-site; USD 35,000 - 45,000; Full time

Job summary

A healthcare services provider is seeking a Medicaid Biller responsible for coordinating the monthly Medicaid billing cycle. This includes managing a high volume of claims, ensuring compliance with billing standards, and processing appeals. Candidates should have a high school diploma and preferred experience in healthcare billing, with strong attention to detail and communication skills. This role includes working in various office settings and handling sensitive information.

Qualifications

• Must be able to read, write, speak, and understand the English language.
• Prior health care billing experience preferred.

Responsibilities

• Coordinate all aspects of the monthly billing cycle for Medicaid revenue.
• Manage high volume of claims efficiently.
• Generate and submit Medicaid claims through third-party portals.

Skills

Billing Compliance

Claims Processing

Attention to Detail

Communication

Education

High School diploma or GED

Tools

Microsoft Office

Billing Software

Job description

Join to apply for the Medicaid Biller role at Pennant

Position Summary

The Medicaid Biller (Medicaid/Managed Care Resource) is responsible for coordinating all aspects of the monthly billing cycle for Medicaid/Managed Care revenue. This position manages a high volume of claims and must work quickly and efficiently to manage the consistent flow of work. Other relevant duties as may be assigned by the AR Market Leader or designee.

Essential Functions And Responsibilities

• Ensures CAPLICO Core Values and Code of Conduct are adhered to at all times.
• Ensures compliance with Resident Rights and HIPAA policies at all times.
• Monitors eligibility and authorizations to assure appropriate steps have been completed to submit clean claims.
• Ensures the proper demographics and diagnosis codes are entered into PCC for billing purposes.
• Responsible for setting up the AR Insurance Tab according to payer guidelines.
• Generates and submits Medicaid claims through Waystar or third-party portal.
• Completes all payer rejections in a timely manner in accordance with contract guidelines.
• Submits appeals and reconsiderations.
• Meets billing compliance standards.
• Identifies and communicates possible system and reimbursement problems to facilitate an efficient and accurate review of the payers.
• Review billing reports to identify areas that may need attention.
• Assists and covers other staff when necessary to maintain productivity and efficiency in the department.
• Processes refunds and write offs.
• Performs PCC Month End Close and uploads all documents to the Month End Close Application.
• May perform other duties as assigned.

Supervisory Responsibility

• None

Working Conditions

• Works in office area(s) as well as throughout the community/facility
• Moves frequently during working hours.
• Is subject to frequent interruptions.
• Is involved with residents, personnel, visitors, government agencies/personnel, etc., under all conditions and circumstances.
• Is subject to hostile and emotionally upset residents, family members, personnel, and visitors.
• Is involved in community/civic health matters/projects as appropriate.
• Is subject to injury from falls, burns from equipment, odors, etc., throughout the work day, as well as to reactions from dust, disinfectants, tobacco smoke, and other air contaminants.
• Is subject to exposure to infectious waste, diseases, conditions, etc., including TB, COVID-19 and the AIDS and Hepatitis viruses.
• May be subject to the handling of and exposure to hazardous chemicals.

Physical Demands and Sensory Requirements

• Must be able to move frequently throughout the workday.
• Must be able to cope with the mental and emotional stress of the position.
• Must be able to see and hear or use prosthetics that will enable the senses to function adequately to ensure that the requirements of this position can be fully met (e.g.: accurately read measurements on resident related equipment such as thermometers, monitors, gauges).
• Must be able to function independently, have personal integrity, flexibility and the ability to work effectively with residents, employees, visitors and support agencies.
• Must be in a good general health and demonstrate emotional stability.
• Must be able to relate and work with the disabled, ill, elderly, emotionally upset and at times, hostile people within the community.
• Ability to stand/walk up to two hours a day, sit up to eight hours a day.
• Must be able to occasionally lift/carry up to 20 pounds.
• Requires frequent kneeling, bending, and reaching.
• Requires sufficient mobility to access the workplace.
• Must be able to assist with the evacuation of residents.

Specific Requirements

• Must be able to read, write, speak, and understand the English language.
• Must not pose a direct threat to the health or safety of other individuals in the workplace.
• Possess the ability to make independent decisions when circumstances warrant such action.
• Possess the ability to deal tactfully with personnel, residents, visitors, and the general public based on whatever maturity level they are currently functioning.
• Ability to be calm and level-headed in emergencies.
• Well groomed, professional and possess ability to work harmoniously with other personnel.
• Ability to seek out new methods and principles and be willing to incorporate them into existing resident care practices.
• Follow written and oral instructions.
• Must be capable of operating computer, copier, postage meter, fax machine, intercom and telephone system.
• Must be capable and comfortable learning and using new computer operating systems, word processing, spreadsheets and e-mail.

Minimum Qualifications

• High School diploma or GED.
• Prior health care billing experience preferred

The Pennant Group, Inc. is a holding company of independent operating subsidiaries that provide healthcare services through home health and hospice agencies and senior living communities located throughout the US. Each of these businesses is operated by a separate, independent operating subsidiary that has its own management, employees and assets. More information about The Pennant Group, Inc. is available at http://www.pennantgroup.com.