Medicaid Specialist – Business Office – Days

Search Results; Beaumont (TX); On-site; USD 40,000 - 60,000; Full time

Job summary

Baptist Hospitals of Southeast Texas is seeking a Medicaid Specialist to ensure accurate Medicaid claims processing and timely billing. You will review remittance reports, identify issues, and prepare necessary appeals as needed.

This role supports accurate patient accounts, monitors denial information, and works to resolve outstanding claims in compliance with federal guidelines, including handling PHI with care.

Qualifications

• 1–3 years experience in Medicaid billing or healthcare billing.
• Knowledge of Medicaid claims processing and remittance
• Ability to work with remittance reports and appeals

Responsibilities

• Reviews and corrects Medicaid final and interim billed claims daily for accurate billing within guidelines.
• Works remittance reports to identify errors and obtain information to rebill/appeal.
• Tracks and ages reports to resolve outstanding claims according to federal guidelines with PHI.
• Monitors inpatient accounts for authorization prior to billing as required.
• Ensures accuracy of accounts and submits corrections/adjustments to patient accounts.
• Enters denial information into the system to facilitate collection of accounts.

Skills

Medical billing

Education

High School diploma or equivalent

Job description

We are looking to add top talent to our Baptist Hospitals of Southeast Texas team.

Join us in performing Sacred Work!

Competitive benefits are offered including:

Matched Retirement Plan

Paid Time Off

Comprehensive Benefit Plan — Medical, Dental, Vision and Much More!

Bonus Potential

Summary/Objective

The Medicaid Specialist ensures that all Medicaid claims are billed timely and accurately. Works remittance and rejection reports daily to identify issues. Processes appeals when applicable.

Essential Job Duties

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Reviews and corrects all Medicaid final and interim billed claims daily for accurate billing within guidelines and notify management of any issues for review and resolution.
2. Works remittance reports from Medicaid to identify errors, denials, recoupments, incorrect payments, etc. and obtains the necessary information to rebill/appeal.
3. Works daily track and aging reports to ensure all outstanding claims are resolved according to federal guidelines with PHI.
4. Monitors Inpatient accounts for authorization prior to billing as required.
5. Ensures the accuracy of accounts as reviewed and when identified, submits corrections/adjustments to the patient account.
6. Ensures denial info is entered into the appropriate system to facilitate collection of accounts.

Required Education and Experience

High School diploma or equivalent

1 — 3 years experience

Required License/Certifications

N/A