Billing Specialist

KEY RESPONSIBILITIES

Prepare and submit Medicaid claims with precision and timeliness
Resolve unpaid, denied, or rejected claims through proactive follow-up
Manage authorizations in billing systems and monitor available units
Post payments, adjustments, and denials to accounts accurately
Collaborate with field staff and Medicaid representatives to resolve billing issues
Stay current with state-specific Medicaid billing regulations
Support individuals and families with Medicaid billing/coverage questions
Generate reports and maintain accurate billing records
Update fee schedules within billing systems
Assist with audits and compliance monitoring
Support credentialing and enrollment applications
Perform month-end closing activities and reconciliations

Requirements
QUALIFICATIONS

Associate Degree in Healthcare Administration or related field or equivalent experience
1-2 years of experience in medical billing (Medicaid billing experience desirable)
Knowledge of CPT/HCPCS/ICD-10 and healthcare billing/EHR systems
Experience with HHAeXchange, PROMISe, and Therap billing/EHR software is a plus
Exceptional attention to detail and organizational skills
Strong communication and problem-solving abilities
Ability to work independently and collaboratively in a fast-paced environment
SPECIALIZED KNOWLEDGE

Strong working knowledge of billing management software and EHR systems
Understanding of industry-specific billing procedures
Financial and billing records maintenance
Problem-solving skills for billing, posting, and reconciliation challenges
Thorough comprehension of Explanation of Benefits (EOB) documents