Medicaid Billing Specialist

We are Hiring-Medicaid Billing Specialist

Remote position based in Oregon or Washington.

We are seeking a detail-oriented Medicaid Billing Specialist to join our team. This role is responsible for processing and managing Medicaid claims for Oregon, ensuring compliance with state-specific regulations, and working closely with healthcare providers to optimize reimbursement.

Benefits:

• A company that is growing
• An awesome team that is passionate about seniors
• Medical, Dental, and Vision Insurance
• Paid Time Off
• Paid Holidays
• 401K/Roth plan and Match
• Company-paid life insurance
• Perks and Discounts Program
• Bright Horizon Childcare
• Educational/Personal Development Reimbursement Assistance

Essential Functions:

• Functions as a billing specialist for two Oregon properties.
• Post payments immediately to the resident ledger in Yardi when received.
• Ensure Yardi is updated with rate changes in a timely manner.
• Submit, track, and reconcile Medicaid claims for Oregon.
• Ensure all claims comply with state Medicaid policies, regulations, and coding guidelines.
• Identify, investigate, and resolve claim denials and rejections promptly.
• Review accounts receivable, follow up on outstanding claims, and appeal denied claims when necessary.
• Collaborate with providers and healthcare staff to verify patient eligibility, prior authorizations, and coverage.
• Maintain accurate documentation of billing activities and payment reconciliations.
• Stay informed about Medicaid policy changes in Oregon and adjust billing practices accordingly.
• Provide CCO with monthly reports related to aging, adjustments, and revenues received.
• Enter monthly billing information into databases.
• Adjust resident ledger by reviewing remittance advice and consulting with the program office.
• Participates in professional educational opportunities to keep current on programs and reimbursement procedures.

Requirements:

• Experience: Minimum 2 years of Medicaid billing experience, preferably in Oregon.
• High school diploma or equivalent required; associates or bachelors degree in healthcare administration, finance, or a related field preferred.
• Proficiency in medical billing software Yardi Claims Manager recommended
• Familiarity with Medicaid rules and claim processing guidelines for Oregon
• Proficient with Microsoft Windows, Microsoft Office and e-mail (Microsoft Outlook or Exchange, preferred).
• Basic typing skills.
• Able to manage revenue and expense budget.
• Able to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
• Must be 18 years or older.
• Must meet all health requirements, including Health screening and TB clearance
• Must pass state required fingerprinting and criminal background process.
• First Aide certification required

Apply with your resume and cover letter TODAY to secure your interview for this exciting opportunity!