Medicaid Billing Specialist

Santa Ana, CA

Job status
Full time
Job description
Are you competitive with a drive to succeed? Do you have strong customer relations skills? Then join Parallon® 's motivated individuals working to resolve patient accounts for hospitals.

The out of state Medicaid biller is responsible for the timely submission of hospital based service claims with various Medicaid payors.
Qualifications
Minimum 2 years of experience in a medical office or healthcare business office; or equivalent combination of education and experience.
Working experience with all payer types including: commercial, governmental, Medicare, Medicaid, HMO, etc. and the ability to cross-over into different payers.
Established experience using Microsoft Excel, Microsoft Word and Microsoft Outlook is required.
Must have excellent verbal and written communication skills.
Understanding of co-pay, coinsurance, and deductibles and intermediate to expert experience in electronic claim submission and edit resolutions, third party payer insurance verification, collections and denial resolution process.
Medical Billing & Coding degree and/or Certification required.
Responsibilities
Understanding Coding and ICD criteria
Knowledge of basic Medicaid billing rules, regulations, and deadline
Submits insurance claims to individual insurance companies electronically or via paper form.
Prepares and submits clean claims to various Medicaid agencies and or assigned payers
Using coded data to produce and submit claims
Analyze remittance advice to ensure accurate posting of rejections, payments and contractual adjustments timely.
Reviewing and appealing unpaid and denied claims
Maintains a working knowledge of payer practices and reimbursement methodologies and becomes a subject matter expert in assigned A/R responsibilities.
Review UB/1500 claims for accuracy and completeness and obtain any missing information as needed for submission
Knowledge of out of state Medicaid billing guidelines
Check each insurance payment for accuracy and compliance with contract discount
Identify and bill secondary or tertiary insurances
Ability to look up ICD 9 diagnosis and CPT treatment codes from online service or using traditional coding references.
Understanding of Remittance Advise details for Medicaid
Other duties as needed.
Working directly with the Medicaid agency to get the claim processed and paid.
Skills
• Excellent written and oral communication skills

• Extreme attention to detail and accuracy.

• Strong customer service skills required.

• General business office knowledge.

• Analytical ability a plus.

• Must be organized and the ability to work well under pressure.

• Meet multiple and competing deadlines.

• The ability to type 45-55 WPM

• Ability to manage 10-key

If you have a disability and require assistance completing the online application, please contact the Human Resources Department of the facility to which you are applying.

About us:
Parallon is one of the healthcare industry's leading providers of business and operational services. We are uniquely equipped to provide a broad spectrum of customized services in the areas of revenue cycle, purchasing, supply chain, technology, workforce management, and consulting. Parallon is committed to supporting healthcare providers, improving the health and well-being of their communities.

We are an Equal Opportunity Employer.
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