Aperion Care
Medicaid Managed Care Specialist – Summary: The Medicaid managed Care Specialist works to review, investigate and follow-up on various insurance claims.
Essential Duties and Responsibilities
Ensure that established accounting procedures are followed for processing insurance claims
Checking for accuracy of information for claim submission.
Monitoring claims processing status, recorded payments and adjustments within the billing system.
Maintain accurate records, up to date billing systems
Managing and submitting appeals, calls, emails and other efforts to obtain insurance coverage payment.
Follow-up on, collect and allocate payments as applicable
Performing collections follow-up process in accordance with established procedures.
Research and Resolve denied claims in a timely fashion
Investigate and resolve customer queries and communicate with customers via phone, email, mail or personally
Assist with preparation of monthly statements, or as requested by supervisor
Other duties as assigned
Qualifications
Experience in Long Term Care industry, preferred
Experienced in Managed Medicaid billing
Experience in Point Click Care (PCC) billing system is preferred
Physical Demands
Must be able to move intermittently throughout the workday.
Seniority level
Entry level
Employment type
Full-time
Job function
Other
Industries
Hospitals and Health Care
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Essential Duties and Responsibilities
Ensure that established accounting procedures are followed for processing insurance claims
Checking for accuracy of information for claim submission.
Monitoring claims processing status, recorded payments and adjustments within the billing system.
Maintain accurate records, up to date billing systems
Managing and submitting appeals, calls, emails and other efforts to obtain insurance coverage payment.
Follow-up on, collect and allocate payments as applicable
Performing collections follow-up process in accordance with established procedures.
Research and Resolve denied claims in a timely fashion
Investigate and resolve customer queries and communicate with customers via phone, email, mail or personally
Assist with preparation of monthly statements, or as requested by supervisor
Other duties as assigned
Qualifications
Experience in Long Term Care industry, preferred
Experienced in Managed Medicaid billing
Experience in Point Click Care (PCC) billing system is preferred
Physical Demands
Must be able to move intermittently throughout the workday.
Seniority level
Entry level
Employment type
Full-time
Job function
Other
Industries
Hospitals and Health Care
#J-18808-Ljbffr