MEDICAID SPECIALIST (1148)

Memorial Health; Springfield (IL); On-site; USD 25,000 - 39,000; Full time

Benefits offered by this job

401(k) match

Health/dental/vision insurance

Paid time off

Job summary

Memorial Health is seeking healthcare billing professionals to analyze, investigate, and resolve Medicaid claims errors for both inpatient and outpatient services. The role emphasizes compliance with Medicaid guidelines and MMC standards, with opportunities to collaborate across teams and with external parties.

The ideal candidate will have 2+ years in healthcare billing, familiarity with Medicaid billing and systems, and strong communication skills.

Qualifications

• High school diploma or GED required.
• Two or more years of insurance or health care billing experience.
• Experience with Medicaid billing and the listed software (IDPA, SMS, NEBO) preferred.

Responsibilities

• Analyzes, investigates, and resolves claims/billing information and/or errors for inpatient and outpatient Medicaid claims.
• Ensures compliance with Medicaid guidelines and MMC policies.
• Demonstrates communication, problem solving, and teamwork to support internal and external customers.

Skills

Microsoft Word

Microsoft Excel

Multitasking

Communication

Problem solving

Medical terminology

CPT coding

ICD-9 CM

UB-04

Customer service

Education

High School/GED

Tools

IDPA payment system

SMS

NEBO

Job description

Focused on the Future of Care

We're looking for talented, passionate healthcare professionals to join the team at Memorial Health as we build the future of healthcare. If you're ready to be part of a transformative organization that puts people first, take a look at what we have to offer.

Position Type: On-site

Job Description Summary: Position Summary: Analyzes, investigates, and resolves claims/billing information and/or errors associated with inpatient and outpatient Medicaid claims. Ensures compliance with Medicaid guidelines and MMC organizational policies. Embodies the Memorial Health System Performance Excellence Standards of Safety, Courtesy, Quality, and Efficiency that support our mission, vision and values.

To review Memorial's Benefits: Benefits - Memorial HR Job Description:

Education and Experience

Education: Education equivalent to graduation from high school or GED is required.

Experience: Two or more years of insurance and/or health care billing experience is required.

Previous experience with Medicaid billing and software (IDPA payment system, SMS, and NEBO) is highly preferred.

Other Knowledge/Skills/Abilities

• Basic working knowledge of personal computers and their associate user software is required. Experience with Microsoft Office products Word and Excel is preferred.
• Ability to multi-task while working on multiple responsibilities simultaneously.
• Demonstrated ability to work successfully with internal customers and external contacts is required.
• Possesses a highly-developed critical thinking and problem solving-ability to work through complex situations.
• Demonstrates excellent oral and written communication, keyboarding, basic math, and problem solving skills.
• Familiarity with medical terminology, medical procedural (CPT) and diagnosis (ICD-9 CM) coding, and hospital billing claim form UB-04 is highly preferred.

Salary and Benefits

Pay Transparency $18.34 - $28.42

Additional compensation in the form(s) of participation in our annual incentive program are dependent on role. Pay is based on factors such as work experience, education, certification(s), training, skills, and competencies related to the role. Memorial Health also offers a comprehensive benefits plan, which includes paid time off, 401(k) match, and health/ dental/ vision insurance options. All benefits can be found at https://jobs.memorial.health/about/benefits/

If you require a reasonable accommodation to complete this application or participate in the hiring process, please contact [e-mail]. Requests will be handled confidentially.