Medicaid Billing Specialist

ICM; United States; Hybrid; USD 42,000 - 62,000; Full time

Job summary

ICM is seeking a Medicaid Billing Specialist to manage customer setup in Therap, perform manual and electronic billing, and monitor eligibility and reporting. The role supports the organization’s fiscal integrity within HIPAA guidelines.

The candidate should have 6 months billing experience (Medicaid preferred) and be able to work in a hybrid environment with the CFO and Controller providing guidance. Strong organizational and analytical skills are essential.

Qualifications

• Two years of college or vocational technical school in Business Administration or related field.
• Bachelor’s degree in Business Administration or a related field preferred.
• Experience in billing processing; Medicaid billing experience preferred.

Responsibilities

• Review, verify and process all PA requests.
• Maintain a list of expiring PA’s and communicate with operations.
• Create customers in Therap and maintain eligibility in Therap.
• Enroll, discharge and maintain customer information in Therap.
• Create customer caseloads in Therap and keep records updated.
• Monitor customer eligibility weekly and prevent lapses.
• Perform manual billing and electronic billing.
• Bill Autism supplies, reimbursable mileage, OHCDS expenses, and therapist billing.
• Maintain source documents and generate billing reports weekly and monthly.
• Assist with audits and ensure compliance with laws and policies.

Skills

Organization

Attention to detail

Communication

Time management

Analytical thinking

Education

Two years of college or vocational tech in Business Administration

Bachelor’s degree in Business Administration or related field

Tools

Microsoft Excel

Job description

The Medicaid Billing Specialist must be well organized and dedicated to maintaining the fiscal integrity of ICM. This position is responsible for performing customer set up in ICM’s EHR system, ensuring all billing documentation is accurately recorded in all ICM systems, manually billing customer payors, electronically billing payers, completing claim analysis, working claim collections, and assisting with other billing functions as needed. As a company dedicated to providing services to individuals with disabilities, ICM is committed to ensuring that our financial operations are accurate, efficient, and in line with the values of care and service that guide our work.

Primary Duties and Responsibilities

The responsibilities described below may not reflect all duties asked of this position but rather indicate categories of work. Duties will include, but will not be limited to the following:

• Review, verify and process all PA requests.
• Review and maintain a list of all expiring PA’s, effectively communicating with operations team regarding expiring PA’s.
• Maintain Customers in Therap :
• Create all customers in Therap, ensuring customer configuration is accurate in accordance with billing requirements.
• Enroll, discharge, and maintain customers and customer information in Therap.
• Create customer caseloads in Therap.
• Maintain accurate records of customer information in Therap.
• Monitor customer eligibility on a weekly basis, notify and work with operations department to ensure no lapse in eligibility.
• Billing and Reporting :
• Complete all manual billing
• Perform electronic billing.
• Accurately bill all Autism supplies, reimbursable mileage billing, OHCDS expenses, and therapist billing.
• Organizes and maintains source documentation such as invoices, expense reports, etc.
• Responsible for weekly and monthly billing reports as assigned.
• Other Duties will include :
• Assists with audit requests.
• The position assists in keeping the agency compliant with all laws, rules and regulations.
• Completes various ad-hoc requests from the Controller and CFO.
• Cross trains with other Finance Department team member roles.
• Other duties as assigned by the Controller and CFO
• Strong ethical standards
• Detail oriented and analytical.
• Ability to plan, execute, and meet deadlines.
• Strong communication skills to effectively interact with team members, management, and outside parties.
• Knowledge of computer fundamentals and business software including database, spreadsheets, and word processing software.
• Proficient with Microsoft office, specifically Microsoft Excel
• Ability to work with sensitive information and to maintain confidentiality.
• Ability to identify billing issues and problem solve to resolve billing discrepancies.
• Ability to research, learn, interpret, and apply rules, regulations and policies pertaining to billing and services.

General Requirements for All ICM Employees

• Understands and endorses ICM’s mission and vision
• Follows all ICM policies and procedures and asks for clarification and explanation when needed
• Understands and complies with all HIPAA regulations
• Maintains a clean and orderly work environment
• Maintains prompt and regular attendance.

Qualifications/Specifications

Education (preferred): Two (2) years of c ollege or vocational technical school course work in Business Administration, or a related area ; Bachelor’s degree in Business Administration or a related field such as Business Administration or Finance preferred

Experience : Minimum of 6 months of experience in billing processing, or related area. Medicaid billing experience preferred, but not required.

Essential Technical/Motor Skills: Ability to perform tasks efficiently. Able to type and use computer efficiently. Able to operate various office equipment such as copier, multi-line phone system, and fax machine.

Interpersonal Skills: Must be able tosuccessfullyinteract and communicate with all levels of staff, clients, and customers in an effective manner exhibiting tact, enthusiasm, and patience. Must be a self-motivator with ability to take ownership of job responsibilities. Must have strong organizational skills.

Essential Physical Requirements: Requires full range of body motion includingsitting, standing,handling and lifting, manual and finger dexterity, and hand-eye coordination. Able to lift and carryitemsup to 25 pounds.

Critical Cognitive Abilities: Requires excellent communication and organizational skills. Requires reasoning ability, use of independent judgment, and discretion. Able to demonstrate competence in project management and time management.Requires work with frequent interruptions.

Work Schedule

Primarily, the days and hours will be Monday – Friday 8 am to 4 pm. Weekends and evenings as needed if emergencies arise. Hours and workdays will vary to accommodate the needs of the customer and ICM. ICM permits a hybrid approach to working remotely and in-office, as approved by the supervisor. This position would allow a hybrid approach of 2-3 remote days per week, on a flexible basis, based on employee supervisor preference.

Qualifications

Experience

Required

Two (2) years of college or vocational technical school course work in Business Administration, or a related area;Bachelor’s degree in Business Administration or a related field such as Business Administration or Finance preferred

Minimum 6 months in billing processing, or related area. Medicaid billing experience preferred, but not required.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.