Medicaid Billing Specialist

Groundworks New Mexico; Albuquerque, Northern (NM, KY); Hybrid; USD 42,000 - 55,000; Full time

Job summary

Adelante is seeking a Medicaid Billing Specialist to support accurate and timely Medicaid claims for our programs in New Mexico. The role focuses on verifying patient eligibility, processing claims, and ensuring compliance with Medicaid guidelines in a service-oriented environment.

You will work on-site in Albuquerque, collaborating with billing and program staff to resolve denials and optimize reimbursement for services to people with disabilities, seniors and other underserved groups.

Qualifications

• 1–3 years of Medical/Medicaid billing experience.
• Experience billing New Mexico Medicaid and/or managed care organizations preferred.
• Working knowledge of medical reimbursement processes, claim forms, and insurance follow-up.
• High School Diploma or GED required.
• Associate degree in Accounting, Healthcare Administration, Business, or related field preferred.

Responsibilities

• Prepare and submit Medicaid claims accurately and on time.
• Verify billing information including eligibility, authorizations, coding, and documentation.
• Monitor and resolve denied or unpaid claims; research issues and resubmit as needed.

Skills

Medical/Medicaid billing experience

Education

High School Diploma or GED

Associate degree (Accounting/Healthcare Administration/Business or related)

Job description

Join Our Team as a Medicaid Billing Specialist!

Behind every successful Medicaid claim is someone who cares about accuracy, problem-solving, and making a difference.

As a Medicaid Billing Specialist at Adelante, you'll play an important role in ensuring our programs receive the funding needed to provide life-changing services for people with disabilities, seniors, and other underserved members of our community.

Additional Areas of Responsibility:

• Prepare and submit Medicaid claims accurately and on time while following federal, state, and payer guidelines.
• Verify billing information, including client eligibility, authorizations, coding, and supporting documentation.
• Monitor and resolve denied or unpaid claims by researching issues, making corrections, and resubmitting claims when needed. Maintain compliance with New Mexico Medicaid regulations, HIPAA requirements, and billing policies.

Other Information/Requirements:

• High School Diploma or GED required.
• Associate degree in Accounting, Healthcare Administration, Business, or related field preferred.
• 1-3 years of Medical or Medicaid billing experience in healthcare, behavioral health, home and community-based services, or similar setting preferred.
• Experience billing New Mexico Medicaid and/or Medicaid managed care organizations strongly preferred.
• Working knowledge of medical reimbursement processes, claim forms, and insurance follow-up.