RCM Medicaid Associate II

Job Description

Job Description

Description : About Our Company

Advanced Diabetes Supply® was founded on the bold principle of creating a knowledgeable, reliable and demonstrably superior diabetes supply company. Our approach, coupled with a commitment to service and innovation, has catapulted Advanced Diabetes Supply® to a national leader in the industry. Creating high-performance, adaptive teams requires a relentless commitment to hiring the best. We strive to maintain a casual, fun environment whenever possible, but we don't just play around. We work hard every day to provide a positive work culture and respectful atmosphere. The standards we set for ourselves are high, and we love to be challenged! If you enjoy working in a collaborative environment, have a passion for excellence and a bias for action, we may be just what you've been looking for.

Interested in learning more about our company and its culture? Visit us at www.northcoastmed.com

About The Position

Hours : 7 : 55 AM - 4 : 25 PM ET, Monday - Friday

Location : Hybrid in Doral, FL

The RCM Medicaid Associate II is responsible for processing insurance claims and billing. The RCM Medicaid Associate II will work within the scope of responsibilities as dictated below with guidance and support from Insurance & Billing leadership teams.

Essential Functions

• Processes claims : investigates insurance claims; properly resolves by follow-up & disposition.
• Verifies patient eligibility with secondary insurance company when necessary.
• Bills supplemental insurances including all Medicaid states on paper and online.
• Mails all paper claims.
• Manages billing queue as assigned in the appropriate system. Investigates and updates the system with all information received from secondary insurance companies.
• Ensures that all information given by representatives is accurate by cross referencing with the patient's account, followed by using honest judgement in any changes that may need to be made.
• Processes denials & rejections for re-submission (billing) in accordance with company policy, regulations, or third party policy.
• Updates patient files for insurance information, Medicaid status, and other changes as necessary or required.
• Keeps email inbox requests up to date at all times; checks for new messages on an hourly basis.
• Complies with HIPAA rules, appropriately safeguarding PHI or other private & confidential information.
• Maintains accurate and detailed notes in the company system.
• Adapts quickly to frequent process changes and improvements.
• Is reliable, engaged, and provides feedback as to improve processes and policies.
• Attends all department, team, and weekly company meetings as required.
• Appropriately routes incoming calls when necessary.
• Meets patient service quality standards.
• Embraces and exemplifies ADS core values :
• We put our people first.
• We serve our members with passion.
• We take ownership.
• We pursue excellence.
• We never stop growing.

Other Responsibilities

Requirements :

Expected Competencies

Physical Demands

The physical demands described below are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable employees with disabilities to perform the essential functions.

While performing the responsibilities of the job, the employee is required to remain in a stationary position most of the time (stand or sit). While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel; and talk or hear. The employee is frequently required to stand, walk and reach with hands and arms. The employee is occasionally required to stoop, kneel, crouch, or crawl. The employee must occasionally lift and / or move up to 15 pounds. Specific vision abilities required by this job include close vision and ability to adjust focus.

Other Requirements

Pay Range and Compensation Package

Pay ranges may vary depending on location. Actual compensation depends on education, experience, and relevant skills. In addition, benefits include :

Equal Opportunity Statement

Advanced Diabetes Supply® provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type based on race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

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