Medicaid Eligibility & Billing Specialist (LTC)

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

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.