Medicaid Collections Billing Specialist

HCA Healthcare, Inc.; Payson (UT); Remoto; USD 45.000 - 65.000; Tempo pieno

Vantaggi offerti da questo lavoro

Comprehensive medical, prescription, 3

Dental, vision, behavioral health and

Paid time off & disability coverage

Tuition assistance and education支

Fertility and family building benefits

Retirement savings plans and stock/pdp

Descrizione del lavoro

HCA Healthcare, Inc. is seeking a Medicaid Collections Billing Specialist for a fully remote role within 60 miles of an HCA hospital in the United States.

You will manage electronic and paper claim submissions, ensure clean Medicaid submissions, and analyze remittance advice to resolve denials and adjustments. Ideal candidates bring 4–5 years in medical billing with Medicaid experience, and a strong understanding of ICD-10/CPT coding and payer practices.

Competenze

• High school diploma or GED required.
• Medical Billing Certification required.
• 4–5 years of experience in related area required.
• Medicaid billing experience preferred.
• 1–2 years acute medical center experience preferred.
• Knowledge of Medicaid guidelines for In-patient admissions preferred.

Mansioni

• Submit insurance claims to individual insurance companies electronically or via paper form.
• Prepare and submit clean claims to various Medicaid agencies and or assigned payers.
• Use coded data to produce and submit claims.
• Analyze remittance advice(s) to ensure accurate posting of rejections, payments and contractual adjustments timely.
• Reviews and appeals unpaid and denied claims.
• Maintain a working knowledge of payer practices and reimbursement methodologies and become a subject matter expert in assigned A/R responsibilities.
• Review UB/1500 claims for accuracy and completeness and obtain missing information as needed for submission.
• Identify and bill secondary or tertiary Payors.
• Ability to look up ICD-10 diagnosis and CPT treatment codes from online service or using traditional coding references.
• Maintain appropriate Productivity requirement(s) for their role.
• Review medical records related to an IP’s clinical presentations and supporting documentation to determine elevated level of care according to claim guidelines per state.
• Submit electronic and paper claims according to Medicaid and department deadlines.
• Collect and enter confidential information into PARALLON’s patient management system.
• Collaborate with the clinical team and further clinical resources in sharpening review strategies for stronger ISD criteria documentation insuring payor approvals.

Conoscenze

Attention to detail

Claims processing

ICD-10/CPT coding lookup

Formazione

High school diploma or GED

Medical Billing Certification

Descrizione del lavoro

This Work from Home position requires that you live and will perform the duties of the position; within 60 miles of an HCA Healthcare Hospital (Our hospitals are located in the following states: FL, GA, ID, KS, KY, MO, NV, NH, NC, SC, TN, TX, UT, VA).

Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized.

Job Summary and Qualifications

The Medicaid Collections Billing Specialist is responsible for the review, edits, submission and collection of both electronic and paper claim submissions for state Medicaid programs and works in conjunction with the Authorization Department.

What you will do in this role:

• Submit insurance claims to individual insurance companies electronically or via paper form
• Prepare and submit clean claims to various Medicaid agencies and or assigned payers
• Use coded data to produce and submit claims
• Analyze remittance advice(s) to ensure accurate posting of rejections, payments and contractual adjustments timely.
• Reviews and appeals unpaid and denied claims
• Maintain a working knowledge of payer practices and reimbursement methodologies and become a subject matter expert in assigned A/R responsibilities.
• Review UB/1500 claims for accuracy and completeness and obtain missing information as needed for submission
• Identify and bill secondary or tertiary Payors
• Ability to look up ICD-10 diagnosis and CPT treatment codes from online service or using traditional coding references
• Maintain appropriate Productivity requirement(s) for their role
• Review medical records related to an IP’s clinical presentations and supporting documentation to determine elevated level of care according to claim guidelines per state
• Submit electronic and paper claims according to Medicaid and department deadlines
• Collect and enter confidential information into PARALLON’s patient management system
• Collaborate with the clinical team and further clinical resources in sharpening review strategies for stronger ISD criteria documentation insuring payor approvals

Qualifications

• High school diploma or GED required
• Medical Billing Certification required
• Minimum 4-5 year(s) of experience in related area required.
• Medicaid billing experience, preferred
• 1-2 years acute medical center experience, preferred
• Knowledge and experience of Medicaid guidelines for In-patient admissions, preferred

Benefits

Parallon, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
• Wellbeing support, including free counseling and referral services
• Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
• Savings and retirement resources , including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
• Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
• Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts

Learn more about Employee Benefits (https://careers.hcahealthcare.com/pages/employee-benefits-and-rewards)

Note: Eligibility for benefits may vary by location.

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"There is so much good to do in the world and so many different ways to do it."- Dr. Thomas Frist, Sr.

HCA Healthcare Co-Founder

Parallon provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities.

HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

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We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.