What are the responsibilities and job description for the Claims (Medicaid) Eligibility Specialist - Local to Robbinsville, New Jersey position at AmeriHealth Caritas?
Founded in 1995,; PerformCare ® ;is a national behavioral health managed care organization that helps health plans and customers provide comprehensive behavioral health management strategies and solutions to optimize clinical outcomes, maximize efficiency, and integrate services. For more;information, visit www.performcare.org
Summary :
The Claims Eligibility Specialist is the point of contact for the Provider community to resolve issues related to Medicaid coverage and services. The incumbent coordinates and collaborates with internal associates and staff from various Provider agencies on Medicaid eligibility and claims issues. ;In addition to resolving discrepancies in coverage, eligibility, enrollment, and billing, the Claims Eligibility Specialist reviews, researches, and investigates claims and authorization data to support the analysis and identification of trends.
- Must live local to Robbinsville, New Jersey
Education / Experience : ;
High School Diploma or equivalent required
Requires :
Minimum one (1) year of experience in; Medicaid Claims and Billing Process
Current / recent in-depth knowledge of coverage and services offered under the Behavioral Health Medicaid Program regarding authorizations, claims, billing, enrollment, and eligibility
Customer service experience, preferably in a healthcare setting;
Experience working in Microsoft Office (Excel, Word, and Outlook);
Strong attention to detail
Ability to quickly and successfully embrace change and adapt effectively in response
Effective communication (listening, verbal, and written) and critical thinking skills
Experience working with an Electronic Medical Record (EMR) preferred
Your career starts now. We are looking for the next generation of healthcare leaders.
At AmeriHealth Caritas, we are passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together, we can build healthier communities. If you want to make a difference, we would like to hear from you.
Headquartered in Newtown Square, Pennsylvania, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.
Discover more about us at www.amerihealthcaritas.com.
Diversity, Equity, and Inclusion
At AmeriHealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.
We keep our associates happy so they can focus on keeping our members healthy.
Our Comprehensive Benefits Package
Flexible work solutions include remote options, hybrid work schedules, competitive pay, Paid Time Off (PTO), including holidays and volunteer events, health insurance coverage for you and your dependents on Day 1, 401(k), tuition reimbursement, and more.
