Senior Claims Specialist

Job Summary

Working remotely in a full-time capacity, the Senior Claims Specialist will manage Medicaid eligibility, authorization, enrollment, and payment posting functions while ensuring compliance with client and Medicaid enrollment guidelines.

Key responsibilities

• Confirm eligibility and authorization requirements for Medicaid patients and submit authorization requests to Medicaid payers
• Perform manual data entry of patient accounts and coordinate with hospitals and physicians to complete Medicaid enrollment applications
• Provide strong customer service to clients and maintain accurate account notation while monitoring account statuses

Required qualifications

• 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, word processing, and proficiency in MS Office applications
• Ability to navigate through multiple web-based applications and meet home internet connection criteria for remote work