Medicaid Billing Specialist

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Irvine, 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.

We are now hiring a Medicaid Billing Specialist to handle out-of-state medical billing.

The out-of-state Medicaid Billing Specialist is responsible for the timely submission of hospital based service claims with various Medicaid payors.
Experience requirements
• 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.
Qualifications
• Established experience using Microsoft Excel, Microsoft Word and Microsoft Outlook is required.
• General business office knowledge.
• Understanding Coding and ICD criteria.
• 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.
• Understanding of Remittance Advise details for Medicaid.
• Medical Billing & Coding degree and/or Certification required.
• Knowledge of basic Medicaid billing rules, regulations, and deadline.
• Knowledge of out-of-state Medicaid billing guidelines.
Responsibilities
• Submit insurance claims to individual insurance companies electronically or via paper form.
• Prepare and submit clean claims to various Medicaid agencies and or assigned payers.
• Use coded data to produce and submit claims.
• Analyze remittance advice to ensure accurate posting of rejections, payments, and contractual adjustments timely.
• Review and appeal unpaid and denied claims.
• Maintain a working knowledge of payer practices and reimbursement methodologies and become 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.
• Check each insurance payment for accuracy and compliance with contract discount.
• Identify and bill secondary or tertiary insurances.
• Work directly with the Medicaid agency to get the claim processed and paid.
Skills
• Must have excellent verbal and written communication skills.
• Extreme attention to detail and accuracy.
• Strong customer service skills required.
• Analytical ability a plus.
• Must be organized and the ability to work well under pressure.
• Able to meet multiple and competing deadlines.
• The ability to type 45-55 WPM.
• Ability to manage 10-key.
• Ability to look up ICD 9 diagnosis and CPT treatment codes from online service or using traditional coding references.

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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