Medicaid Revenue Specialist

Job Summary

Ensuring proper submission and adjudication of Medicaid claims, the full-time remote Medicaid Revenue Specialist will verify patient eligibility, analyze claim payments, and manage documentation to facilitate prompt reimbursement.

Key Responsibilities

• Verify patient eligibility and analyze Medicaid claim payments for compliance with state fee schedules
• Research and acquire necessary medical records to support claims and ensure timely reimbursement
• Conduct follow-up with payers and manage both inbound and outbound calls regarding claims status

Required Qualifications

• High School Diploma or GED required; Associate's or Bachelor's Degree preferred
• 1-2+ years of experience in healthcare billing or collections
• 1+ years of client-facing/customer service experience
• 1+ years of experience with UB-04 billing and collections required
• Intermediate understanding of insurance payer/provider claims processing