What are the responsibilities and job description for the Managed Medicaid Specialist position at Aperion Care?
Medicaid Managed Care Specialist SUMMARY:The Medicaid managed Care Specialist works to review, investigate and follow-up on various insurance claims.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Ensure that established accounting procedures are followed for processing insurance claims
- Checking for accuracy of information for claim submission.
- Monitoring claims processing status, recorded payments and adjustments within the billing system.
- Maintain accurate records, up to date billing systems
- Managing and submitting appeals, calls, emails and other efforts to obtain insurance coverage payment.
- Follow-up on, collect and allocate payments as applicable
- Performing collections follow-up process in accordance with established procedures.
- Research and Resolve denied claims in a timely fashion
- Investigate and resolve customer queries and communicate with customers via phone, email, mail or personally
- Assist with preparation of monthly statements, or as requested by supervisor
- Other duties as assigned
- Experience in Long Term Care industry, preferred
- Experienced in Managed Medicaid billing
- Experience in Point Click Care (PCC) billing system is preferred
- Must be able to move intermittently throughout the workday.
