Senior Billing Specialist - Medicaid

Senior Billing Specialist

The Carmelite System is a multi-state not-for-profit senior living organization sponsored by the Carmelite Sisters of the Aged & Infirm. The Carmelite Sisters operate a network of skilled nursing facilities throughout the United States.

We are seeking to hire a Senior Billing Specialist - Medicaid for a fully-remote role within our finance department supporting multiple senior living facilities throughout the United States.

• This is a remote job.
• $65,000 to $72,000 annually based on skills and experience.

Senior Billing Specialist - Medicaid:  This role is assigned to the Medicaid payer group to bill and manage under the direction of the Billing Manager; Cross-train for other roles; Mentor and assist with the training of other staff.

Senior Billing Specialist - Medicaid Qualifications

• High School diploma or the equivalent.          
• Extensive working experience of Medicaid in multiple states, with knowledge of Medicare and other commercial payers.
• 2+ years experience using PCC (Point Click Care). 
• Requires excellent written and verbal communication skills and strong customer service skills.
• Requires an extensive working knowledge of accounts receivable functions including CPT and ICD-10 coding.
• Requires proficiency in working with a PC, the Internet, and MS Windows.
• Required proficiency in medical terminology.

Senior Billing Specialist - Medicaid Job Summary

• Train and Supervise billing staff for assigned payer providing guidance on proper billing procedures, compliance, and customer service.
• Collaborate with facility departments such as admissions, and healthcare providers to gather necessary information for billing purposes.
• Communicate with insurance companies, government agencies, and third-party payers.
• Analyze billing trends and implement improvements.
• Prepare, review, and transmit claims using billing software. Must have excellent knowledge in identifying and correcting coding errors.
• Analyze explanation of benefits forms to review denial codes and make appropriate corrections.
• Follow up on balances, unpaid claims, appeals & denials within the set timeframe.
• File all charge, payment, adjustment batches, refund requests and write off requests in the appropriate format and place (PCC and shared drive)
• Prepare and review claims for billing prior to triple check.
• Attend and lead monthly triple check reviews. Make necessary corrections to claims prior to submitting.
• Monitor reimbursement from managed care networks and insurance carriers to ensure reimbursement consistent with contract rates and fee schedules
• Accurately post payments and adjustments to accounts and maintain backup records.

This is a brief overview of job responsibilities and not intended to be all inclusive.

We aim to create a supportive workplace where you are valued, compensated fairly and provided the tools to thrive!

The Carmelite System Can Offer You

• Competitive Compensation
• Health (Aetna), Dental, Vision, HSA with employer contribution
• Student Loan Forgiveness Guidance
• Flexible Spending Account
• Fully paid Life and Long-Term Disability insurance
• Benefits available 1st of the mo. following 30 days
• AFLAC and supplemental life insurances
• Employee Assistance program with Discount Marketplace
• Retirement Plan
• Generous Paid-Time-Off with 11 paid Holidays

Please consider joining our team working where The Difference is Love℠!

The Carmelite System, Inc. is an Equal Opportunity Employer and adheres to a policy that prohibits discrimination on the basis of race, color, sex, sexual orientation, gender identity, religion, creed, national or ethnic origin, citizenship status, age, disability, veteran status, and any other legally protected class.

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