What are the responsibilities and job description for the Medicaid Billing Specialist position at State of New Mexico?
23.07 - $36.91 Hourly
47,989 - $76,782 Annually
This position is a Pay Band 65
Posting Details
We are so pleased that you are interested in making an impact through our work at CYFD! The department thrives on dedicated, empathetic, and talented employees who ensure the well-being of the children and families in New Mexico by keeping them safe and healthy.
By joining CYFD, you'll work to find the best ways to support families through difficult situations using community-based prevention and intervention programs. Employees have teammates and a committed leadership team to support them every day.
We look forward to you joining us because caring for and supporting New Mexico's children and youth will take all of us. I know the department's mission is critical to improving the overall well-being of children in our state and, in turn, strengthening the future of New Mexico.
THIS JOB POSTING WILL BE USED FOR ONGOING RECRUITMENT AND MAY CLOSE AT ANY TIME. APPLICANT LISTS MAY BE SCREENED MORE THAN ONCE.
If we are unable to fill this position prior to January 22nd, we will take this position to the CYFD Statewide Rapid Hire event on January 23, 2024
Why does the job exist?
This position is responsible for the analysis, oversight, planning and coordination to support CYFD billing for Medicaid services. This position provides overall support monitoring the program responsibilities of CYFD, providing advanced program analysis, planning and consultation services.
How does it get done?
Analyze activities to ensure that the services that are being submitted for payment are in fact for a Medicaid-eligible client who received eligible services during the eligible time-period and signed off by the appropriate provider, along with all of the appropriate documentation.
Train and coordinate JJS Facility and Field staff state-wide to provide proper documentation for eligible Medicaid services.
Comply with all instructions, directives, billing, reimbursement, audit, recoupment, and withholding provisions made available by the Heath Care Authority (HCA).
Obtain, maintain, and keep updated program rules and instructions on billing and utilization review and other pertinent material made available by HCA.
Assess and properly code Medicaid eligible service bills and submit the data into the NM Medicaid Portal.
Who are the customers?
Juvenile Justice leadership, JJS Medical Services Department, and Facility Classification.
Will communicate and report billing activities to Administrative Service leadership for monitoring.
Ultimately our customers are of clients who will receive improved re-entry services.
Ideal Candidate
Experience submitting Medicaid Billing through the New Mexico Medicaid Portal. Analyze, interpret, and resolve all billing edits to ensure claims are filed accurately within the Medicaid regulations and filling limits. Verify Medicaid eligibility. Interface with providers.
Minimum Qualification
Bachelor's degree in Business Administration and two (2) years of experience in the procedures of business and management principles involved in strategic planning. Any combination of education from an accredited college or university in a related field and / or direct experience in this occupation totaling six (6) years may substitute for the required education and experience.
Substitution Table
These combinations of education and experience qualify you for the position :
Education Experience Education Experience 1 High School Diploma or Equivalent AND 6 years of experience OR High School Diploma or Equivalent AND 6 years of experience 2 Associate's degree in the field(s) specified in the minimum qualification AND 4 years of experience Associate's degree or higher in any field AND 6 years of experience 3 Bachelor's degree in the field(s) specified in the minimum qualification AND 2 years of experience 4 Master's degree or higher in the field(s) specified in the minimum qualification AND 0 years of experience
- Education and years of experience must be related to the purpose of the position.
- If Minimum Qualification requires a specific number of "semester hours" in a field (e.g. 6 semester hours in Accounting), applicants MUST have those semester hours in order to meet the minimum qualifications. No substitutions apply for semester hours.
Employment Requirements
Must possess a valid Driver's License. Pre-employment criminal background check is required and conditional pending results.
Working Conditions
Work is performed in an office setting with exposure to Visual / Video Display Terminal (VDT) and extensive personal computer and phone usage
Supplemental Information
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Agency Contact Information : Greg Nelson, (505) 331-8562. Email
For information on Statutory Requirements for this position, click the Classification Description link on the job advertisement.
Bargaining Unit Position
This position is covered by a collective bargaining agreement and all terms / conditions of that agreement apply and must be adhered to.
Salary : $47,989 - $76,782
