Account Manager

• Performs client data entry to include billable services, client payments, Medicaid/Insurance status, and prior authorizations (PA)
• Determines eligibility status of Medicaid and Insurance clients. Aggressively pursues other resources available through third party insurance to ensure payment for services performed
• Obtains MCO prior authorization (PA). Maintains PA expirations and follows up with staff. Responsibility for resolving discrepancies and assisting the Agency in the Medicaid compliance requirements
• Prepares and submits Medicaid and Insurance claims
• Processes Explanation of Benefits (EOBs), remittance advices, and provides appropriate information to rectify discrepancies if necessary
• Works all RCM and CareLogic errors daily
• Meets with clients concerning payment agreements and billing issues
• Verifies accuracy of monthly client billing and processes the mailing of client statements, including processing of any returned mail
• Scans and attaches documents into electronic health record as needed
• Assists with GEAR and Debt Set-off submission and collections
• Performs related duties as assigned
• Attends related state Medicaid and other trainings as required
• Serves on Agency committee(s) as requested

Experience in Medical Insurance/Billing and Admin work

• medical
• vision
• dental
• life and disability insurance
• 401(k) plan