Medicaid Billing Specialist FQHC Revenue Cycle

Health Partners; Lima (OH); On-site; USD 42,000 - 62,000; Full time

Job summary

Health Partners of Western Ohio is seeking a Fulltime In Person Accounts Receivable Specialist in Lima, OH. You will manage Medicaid claims, ensure accurate billing, and support the revenue cycle within a nonprofit health care setting.

Responsibilities include reviewing coverage, submitting claims, reconciling payments, and collaborating with internal teams to resolve complex deny issues while maintaining coding compliance with CPT, CDT, and ICD-10-CM guidelines.

Qualifications

• Knowledge of FQHC billing requirements.
• Experience reviewing insurance coverage and patient demographics for billing.
• Familiarity with Medicaid payers and remittance processing.
• Ability to coordinate with internal teams on claim issues.
• Knowledge of CPT, CDT, ICD-10-CM coding.

Responsibilities

• Review insurance coverage and patient demographic information for billing accuracy.
• Prepare, submit, and track insurance claims to Medicaid payers per rules.
• Process reimbursements and reconcile remittance with payments.
• Monitor accounts receivable aging and follow up on unpaid or underpaid claims.
• Identify denial trends and eligibility discrepancies; resolve credits and overpayments.
• Maintain knowledge of FQHC billing rules and coding requirements.
• Respond to inquiries from patients, providers, and insurers.
• Coordinate with Medicare, Managed Medicaid, and third-party teams to resolve issues.
• Review incoming correspondence related to claims and payments.
• Maintain organized electronic claim records for audits.

Job description

Health Partners of Western Ohio is seeking a Fulltime In Person Accounts Receivable Specialist in Lima, OH. You will manage Medicaid claims, ensure accurate billing, and support the revenue cycle within a nonprofit health care setting.

Responsibilities include reviewing coverage, submitting claims, reconciling payments, and collaborating with internal teams to resolve complex deny issues while maintaining coding compliance with CPT, CDT, and ICD-10-CM guidelines.