Medicaid Claims Specialist

Job Summary

A company is looking for a Senior Claims Specialist to conduct Medicaid eligibility, authorization, enrollment, and payment posting functions.

Key Responsibilities

• Confirm eligibility and authorization requirements for Medicaid patients and submit authorization requests
• Perform manual data entry of patient accounts and coordinate enrollment applications with hospitals and physicians
• Manage client and Medicaid enrollment guidelines, ensuring compliance with state and federal regulations

Qualifications and Requirements

• High School Diploma or GED
• 2-3 years of related experience in the healthcare industry or a related area
• Working knowledge of ICD9, CPT codes, HIPAA, HCPCS, and Medicaid preferred
• Required computer skills, including data entry and proficiency in MS Office applications
• Remote positions require a home internet connection that meets specified criteria