Medicaid Accounts Receivable Specialist

Jacksonville, FL 32257
Under the supervision of the Account Receivable Manager, the Medicaid Accounts Receivable Specialist processes all Medicaid billing. S/he coordinates with the Medicaid Specialist on a variety of Medicaid pending cases, including reviewing Notice of Case Actions from the Department of Children and Families for accurate billing.
Position Details

• In-Office Position. This is an in office position; no work from home is allowed at this time.
• Compensation: Base Salary plus full benefits package; including 23 days of PTO annually

Job Responsibilities

• Handles daily admissions for patients admitted with Medicaid primary or Medicaid for room and board billing. This includes checking eligibility using the Fiscal Agent website for program and payer. The payer and policy ID will be keyed into the billing Suncoast software.
• Confirms Medicaid eligibility using the Fiscal Agent website on all newly approved Medicaid patients.
• Communicates all Medicaid approvals to the Long-Term Care billing office staff via fax or e-mail.
• Prepares all Notice of Case Actions received from Department of Children and Families for scanning and scans to electronic library for placement in the Forcura system.
• Processes billing for Medicaid and Medicaid room and board patients; including all Managed Care plans, monthly ensuring that all billable services are properly billed.
• Transmits all Medicaid billing electronically using the Waystar third party agent meeting deadlines for expedient payment.
• Prepares and post all Medicaid claims adjustments necessary from prior periods and include them in the current month end reconciliation.
• Submits all Medicaid claims adjustments using the Waystar third party agent for payment.
• Responsible for oversight of HOLD claim list to ensure timely claims filing. These would include ICF, pending Medicaid, and secondary claims created.
• Provides the A/R Manager with an itemization of all bad debt, voids, and adjustments monthly.
• Reconciles the A/R ledger with the General Ledger for Medicaid billing following time restraints set by employee and management.
• Researches assigned correspondence; takes necessary action to resolve requests.
• Follows up on all Medicaid claims denials using Waystar within 72 hours to ensure timely reimbursement.
• Reviews and works death and discharges patients for DCF notification.
• Reviews and works the daily change of status report which includes new referrals, level of care changes. Long term care placement, and possible Medicaid referrals.
• Ensures daily accomplishments contribute toward department goals for AR.
• Completes special projects and other duties as assigned by management.

Education & Desired Experience
Any combination of education and/or experience that would provide the required skill and knowledge for successful performance would be acceptable. Typical qualifications would be equivalent to:

• Three (3) years experience with Accounts Receivable medical billing and insurance claims filing, preferably in a hospital setting (minimum).

Knowledge & Skills

• Comprehensive understanding of the various Medicaid plans.
• Medicaid eligibility criteria and billing requirements.
• Strong excel skills.
• Strong analytical and problem-solving skills with attention to detail.
• Excellent written and oral communication skills.
• Time management and prioritization skills.
• Ability to work independently and with minimum supervision.

We are an equal opportunity employer.
We do not discriminate on the basis of race, color, religion, marital status, age, national origin, disability, pregnancy, genetic information, gender, sexual orientation, veteran status, or any other status protected under federal, state, or local law.