Medicaid Billing Specialist Remote

Opco-Skilled-Management-; Albuquerque (NM); Remote; USD 52,000 - 76,000; Full time

Benefits offered by this job

Healthcare

Dental

Vision

PTO

401K

Job summary

Opco-Skilled-Management- seeks a Medicaid Advocate to review Medicaid Pending applications and renewals for assigned facilities, ensuring eligibility for timely coverage and approvals. Provides ongoing support to Regional AR staff, BOM and ABOM in billing, claims, eligibility and authorization across payer types.

Responsibilities include tracking, coordination with facilities, and biweekly calls to discuss statuses. Travel may be required with a valid driver’s license and automobile insurance.

Qualifications

• Experience in the Medicaid application/renewal process in LTC facilities.
• Experience with TMHP and SimpleLTC portals preferred.
• Proficient computer skills.
• Well organized and able to multitask.
• Attention to detail.
• Travel ability with valid driver’s license and automobile insurance.

Responsibilities

• Review referrals and Medicaid questionnaire from assigned facilities to determine eligibility.
• Review all applications and supporting documentation prior to submission to HHSC.
• Communicate with residents and/or family members regarding the application process and required documents.
• Maintain tracking system for Medicaid Pending residents to approval.
• Monitor Medicaid renewals to avoid interruptions in coverage.
• Email coordination with facility and Regional Business Office Consultant for information needed.
• Attend biweekly calls with facilities and Regional Business Office Consultant to discuss statuses and denials.
• Assist training of Business Office staff on Medicaid processes.
• Report delays, barriers or denials to Senior Medicaid Advocate.
• Report weekly on outstanding items and denials.

Skills

Proficient computer skills

Job description

Job Type: Full-Time.

Benefits Offered:

• Healthcare
• Dental
• Vision
• PTO
• 401K

Your Job Summary:

The Medicaide Advoctage will be responsible for reviewing the Medicaid Pending applications and Medicaid renewals for assigned facilities to ensure Medicaid eligibility to obtain timely coverage and approvals. Provides ongoing support to Regional AR staff, BOM and ABOM in the areas of billing, claims, eligibility and authorization process for all payer types, such as Medicaid, Medicare, Managed Care, etc.

Your Qualifications

• Experience in the application/renewal process for Medicaid in LTC facilities
• Experience with TMHP and SimpleLTC portals preferred
• Proficient computer skills
• Well organized and able to multitask
• Attention to detail
• Ability to travel, which includes a valid driver’s license and automobile insurance

Your Responsibilities

Principal Responsibilities

• Review referrals and Medicaid questionnaire from assigned facilities to determine eligibility for Medicaid.
• Review all applications and supporting documentation prior to submitting to HHSC.
• May have communication with the residents and/or family members regarding the application process and supporting documentation needed.
• Maintain tracking system for all assigned Medicaid Pending residents to approval.
• Maintain tracking system to monitor Medicaid renewals to avoid interruption in coverage.
• Email communication with the facility and Regional Business Office Consultant to obtain information needed for the application process or renewal.
• Attend biweekly calls with assigned facilities and Regional Business Office Consultant for assigned facilities to discuss statuses, approvals, denials and any information needed from the facility.
• May assist with training the Business Office staff on the Medicaid application process.
• Report any delays, barriers or denials to the Senior Medicaid Advocate.
• Report weekly to the Senior Medicaid Advocate any outstanding items needed for application/renewal completion as well as the status on any denials.
• Ensure compliance with all State laws in relation to your position.
• Adherence to the Organization’s Compliance Plan and Code of Ethics.
• May occasionally assist other departments within the Central Billing Office.
• Other duties, responsibilities and activities may change or assigned at any time with or without notice.