Billing Specialist

• Prepare, review, and submit Medicaid claims accurately and in a timely manner.
• Verify patient Medicaid eligibility and coverage prior to billing.
• Ensure services are billed in compliance with Medicaid, state, and federal regulations.
• Monitor claim status, identify denials, and resolve rejections or underpayments/overpayments.
• Research and correct billing errors, including coding, documentation, and authorization issues.
• Post payments, adjustments, and denials accurately into billing systems.
• Follow up on unpaid or underpaid claims to ensure reimbursement.
• Maintain up-to-date knowledge of Medicaid billing rules, coding changes, and policy updates.
• Communicate with Medicaid representatives, providers, and internal staff regarding claim issues.

ADDITIONAL JOB DUTIES (Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.)

• Maintain accurate billing records and documentation for audits and compliance reviews.
• Collaborate with service department teams to ensure accurate, timely, and compliant billing processes.
• Assist with internal audits and quality assurance related to billing.
• Support month-end reporting processes as needed.

SKILLS

• Analytical and problem-solving skills
• Strong written and verbal communication skills.
• Ability to work independently and as part of a team.
• Organizational and time management skills.
• Commitment to confidentiality and compliance.

• Associate degree in finance or accounting preferred.
• 2+ years of experience in billing or revenue cycle management.
• Working knowledge of billing guidelines and claim submission processes.
• Exceptional attention to detail and accuracy.
• Ability to manage multiple priorities and meet deadlines.