Medicaid Claims Specialist: Denials & Appeals

LCMC Health; New Orleans (LA); On-site; USD 38,000 - 56,000; Full time

Job summary

LCMC Health in New Orleans is seeking a detail-oriented billing specialist to manage daily follow-up and denial accounts, identify underpayments, review EOBs and coordinate with payers for timely reimbursement.

This role requires accurate documentation, HIPAA compliance, and collaboration with internal teams to resolve appeals and ensure proper patient reimbursement and reporting. You will monitor trends and assist in training teammates.

Qualifications

• A high school diploma/ GED or appropriate work experience in healthcare particularly in billing, collections, payment processing, or denial management is preferred.

Responsibilities

• Maintain responsibility for accurate and timely completion of daily follow-up or denial account assignment.
• Identify and analyze underpayments; process denials and appeals.
• Review posted payments and adjustments to ensure accuracy.
• Analyze EOBs to ensure proper reimbursement.
• Conduct research to complete appeals with third party payers in a timely manner.
• Communicate with payers on outstanding claims, resolve payment variances and achieve timely reimbursement.
• Document all activity on the patient account.
• Collaborate with internal departments and external organizations to ensure correct reimbursement and resolve appeals.
• Monitor underpaid and denied claims for trends and report findings to supervisor.
• Observe best practice processes in follow-up and customer service activities.
• Participate in staff training on Medicare/Medicaid requirements and follow-up processes.
• Act in accordance with LCMC Health’s mission and values, while serving as a role model for ethical behavior.
• Adhere to HIPAA regulations and facility guidelines.

Education

High school diploma or GED

Job description

LCMC Health in New Orleans is seeking a detail-oriented billing specialist to manage daily follow-up and denial accounts, identify underpayments, review EOBs and coordinate with payers for timely reimbursement.

This role requires accurate documentation, HIPAA compliance, and collaboration with internal teams to resolve appeals and ensure proper patient reimbursement and reporting. You will monitor trends and assist in training teammates.