Revenue Specialist, Out of State Medicaid

📋 Description

• Position Summary: Ensure proper submission/adjudication of Medicaid claims; handle PHI securely.
• Verify patient eligibility when needed.
• Analyze Medicaid claim payments; verify reimbursements align with state fee schedules.
• Research and obtain medical records; submit with claims for prompt reimbursement.
• Review UB-04 components for accuracy; update per billing laws.
• Follow up with payers by phone to ensure claims are received and reimbursed promptly.

🎯 Requirements

• HS Diploma or GED required; Associate's or Bachelor's preferred.
• 1-2+ years in healthcare billing/collections.
• 1+ years client-facing/customer service experience.
• 1+ year UB-04 billing/collections; CMS-1500 a plus.
• Intermediate understanding of payer/provider claims processing.
• Intermediate Medicaid payer knowledge preferred.