Medicaid Follow-Up Specialist

Job Summary

To support the efficient processing of claims, the full-time remote Medicaid Follow-Up Specialist will manage the timely editing, submission, and follow-up of assigned claims across various payer types, ensuring compliance with departmental standards and providing guidance to team members.

Key responsibilities:

• Ensures timely submission of clean claims and resolves complex issues related to claims processing
• Reviews and analyzes claims for accuracy, identifies denials, and communicates with relevant stakeholders for resolution
• Maintains detailed records of claim statuses and assists in training junior financial services representatives

Required qualifications:

• Associate degree or three additional years of relevant experience
• Minimum of 5 years of experience in healthcare revenue cycle management, focusing on Medicaid claims
• In-depth knowledge of Medicaid policies and regulations
• Proficiency in healthcare billing software and systems
• Strong analytical skills for interpreting complex claim data