What are the responsibilities and job description for the Medicaid Biller position at Management MCOA, LLC?
The Medicaid Biller will process and follow up on Medicaid billing, review remittance advice forms to verify proper reimbursement, and adjust as necessary.
Duties/Responsibilities:
- Checks to ensure that hospital records for patients include all information required for Medicaid reimbursement.
- Verifies correct Medicaid coding to ensure prompt payment.
- Inputs correct billing information and transmits electronically to the Medicaid carrier.
- Consults with claim clerks in the Medicaid office about any disputed claims and follows up on all bills not processed within usual claim period.
- Reviews remittance advice forms to determine any adjustments made to bills as submitted and consults with the Medicaid office.
- Authorizes or adjusts hospital bills to correct errors.
- Prepares weekly and monthly reports of Medicaid billing for the Controllers office.
- Attends training to keep abreast of changes in Medicaid billing procedures and attends annual in-services (fire, safety, and infection control.)
Culture
This is a high performance, ever-evolving environment propelled by collaboration through our Teams of Excellence (T.O.E.) Program. The expectation for each team member is to provide a supportive high performance work environment.
Work Environment
This job operates in a post-acute setting. This role requires regular walking to various locations around the facility. This role potentially comes into contact with patients who may have contagious illnesses. Team member is expected to adhere to the facility’s no-smoking policy.
Physical Demands
While performing the duties of this job, the team member is regularly required to talk and hear. This position is active and requires standing, walking, bending, kneeling, and stooping. The team member may occasionally lift and/or move items over 20 pounds.
Position Type and Expected Hours of Work
This is a position in an assisted living setting that is open 24 hours a day, 365 days a year. Weekend and holiday shifts may be required.
Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for their job. Duties, responsibilities, and activities may change at any time with or without notice.
HIPAA
Team members are required to adhere to policies and procedures implementing HIPAA requirements for the privacy and security of protected health information. Team members are permitted to use and/or disclose only a minimum amount of Protected Health Information necessary to complete assigned tasks. Report all suspected violation of company’s HIPAA policies or procedures to facility CEO.
Knowledge, Skills and Abilities
1. Ability to communicate positively and effectively with internal and external customers at all levels of the organization
2. Strong computer and Microsoft Application skills. Must have an ability to learn new systems
3. Ability to work with a culturally diverse customer and team member population
4. Must have positive communication skills and demonstrated adequate maturity and patience
5. Proficient in the English language. Excellent communication (verbal and written), customer service and interpersonal skills
6. Must have excellent organizational skills with attention to detail
7. Must be able to successfully prioritize workload, demonstrate initiative, and analyze situations to make sound decisions
8. Ability to maintain a calm, professional demeanor under pressure
9. Must be observant, show initiative and take action on observed needs
10. Must maintain first impression perfection at all times
11. Self-directing with the ability to work with minimal direct supervision
12. Flexibility in responding courteously to immediate needs of internal and external customers and callers; ability to establish priorities and maintain productivity despite numerous interruptions
13. Ability to organize, efficiently document and routinely update information; ability to apply procedures to work problems and situations
Required Education/Experience
- High School Diploma or Equivalent
- A minimum of three (3) years’ experience in accounts receivable, collections or a similar role
Preferred Education/Experience
- College/University Degree in Accounting or Business