Medicaid Billing Specialist Job at Pafford EMS

Medical Billing Specialist

We are looking for a detail-oriented Medical Billing Specialist to join a team i...

Location

United States , King of Prussia

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

At least 1 year of experience in medical billing, claims, or collections
Proficiency in accounting software systems and electronic health record (EHR) systems
Familiarity with Medicaid processes and commercial insurance claims
Strong understanding of accounts receivable, denial management, and appeals
Experience working with billing and authorization functions
Ability to accurately input and manage billing data
Excellent communication skills to collaborate with team members and external payors
Knowledge of compliance policies related to medical billing and collections

Job Responsibility

Process and submit primary and secondary claims for both commercial insurance and Medicaid
Investigate and resolve claim denials, performing appeals as necessary to ensure proper reimbursement
Manage accounts receivable by following up on claims through resolution, including correcting billing errors and addressing rejections
Input and review billing data for accuracy, ensuring compliance with company policies and procedures
Collaborate with the Billing Manager and clinic teams to ensure accurate and timely billing
Track and verify Medicaid status for clients while maintaining relationships with payors to facilitate successful claims processing
Assist intake teams with Medicaid documentation for new clients and those requiring reassessment
Utilize various insurance portals and systems, including Waystar, to handle denial responses and claims follow-ups
Ensure adherence to compliance standards in all billing and collections activities
Perform other tasks as assigned by the Billing Manager or Director

What we offer

Medical insurance
Vision insurance
Dental insurance
Life insurance
Disability insurance
401(k) plan

Fulltime

Billing Specialist

Robert Half is partnering with a healthcare client in the recruiting for a Billi...

Location

United States , Oconomowoc

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

High school diploma or equivalent required
associate or bachelor’s degree in accounting, finance, or a related field preferred
Minimum of 2-3 years of experience in billing, account receivables, accounting preferably within a healthcare or senior living environment
Familiarity with Medicare, Medicaid, and private insurance billing processes is strongly desired
Expertise with billing software and tools (e.g., point-of-sale systems, accounting software, or healthcare billing platforms)
Strong attention to detail and accuracy in financial data entry and reconciliation
Excellent customer service and communication skills, with the ability to address sensitive conversations professionally
Proficient in Microsoft Office Suite, especially Excel and Word
Knowledge of HIPAA and other relevant regulations governing billing and financial data confidentiality.

Job Responsibility

Prepare and process monthly resident billing statements for services, housing, and additional care
Ensure accurate calculation of fees, expenses, and adjustments based on contracts and service changes
Manage third-party billing, including Medicare, Medicaid, private insurance, and long-term care providers
Monitor accounts receivable and follow up on outstanding balances to ensure timely payments
Process incoming payments via check, electronic transfer, and credit card, applying them correctly to resident accounts
Work with residents and families to address billing questions, payment plans, and financial discrepancies
Maintain billing records that comply with federal, state, and local regulations, including HIPAA requirements
Stay updated on relevant Medicare and Medicaid billing guidelines to ensure compliance
Prepare and submit reports for audits and regulatory purposes as needed
Reconcile charges, payments, and account balances on a routine basis to ensure the accuracy of resident accounts

What we offer

403b retirement planning
FSA
tuition assistance
paid time off
paid holidays

Fulltime

Billing Specialist

Location

United States

Salary:

Not provided

Pafford EMS

Expiration Date

Until further notice

Requirements

Proficient with a PC
Knowledge of Health Insurance Portability and Accountability Act (HIPAA)
Knowledge of procedure and diagnostic codes (HCPCS and ICD-10 codes)
Knowledge of medical terminology
Knowledge of Medical Billing
Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and commercial payers
Customer service skills for interacting with patients regarding medical claims and payments
Problem-solving skills to research and resolve discrepancies, denials, appeals, and collections
Ability to work independently and with a group
Working knowledge of MS Word, Excel

Job Responsibility

Obtain referrals and pre/post-authorizations for ambulance services
Check eligibility and benefits verification
Review insurance and facility claims for accuracy and completeness
Prepare, review, and transmit claims using billing software, clearinghouse, and payer websites
Following up on unpaid claims within standard billing cycle timeframe
Reviewing underpaid claims for appropriate escalation steps to ensure appropriate reimbursement for services
Calling insurance companies regarding any payment discrepancies
Identifying and billing secondary or tertiary insurance
Processing incoming mail and taking appropriate follow up actions to resolve accounts
Researching and appealing denied claims

Medical Billing Specialist

We are seeking a dedicated and detail-oriented Medical Billing Specialist to joi...

Location

United States , Hagerstown

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

High school diploma or equivalent
Associate’s degree in Health Information Technology, Business Administration, or a related field is preferred
1+ years of experience in medical billing and accounts receivable, preferably within a healthcare setting
Strong knowledge of medical terminology, coding systems (CPT, ICD-10, HCPCS), and insurance regulations
Experience with medical billing software and electronic health records (EHR) systems
Excellent communication skills, both verbal and written
Detail-oriented with strong organizational and analytical skills
Ability to manage multiple priorities and meet deadlines in a fast-paced environment
Knowledge of HIPAA regulations and confidentiality requirements

Job Responsibility

Billing & Coding: Accurately review and submit medical claims to insurance companies, government programs (e.g., Medicare, Medicaid), and patients based on services provided
Accounts Receivable Management: Monitor and follow up on unpaid claims and accounts, ensuring timely resolution and payment collection
Claim Denial Management: Investigate and resolve denied or rejected claims, working with insurance providers to rectify issues and ensure proper reimbursement
Payment Posting: Post payments, adjustments, and denials to patient accounts accurately
Patient Communication: Communicate with patients and insurance companies to resolve billing inquiries, provide payment information, and answer any questions related to their accounts
Account Reconciliation: Ensure all accounts are reconciled and balanced, identifying discrepancies and making necessary adjustments
Compliance: Maintain up-to-date knowledge of relevant billing codes, insurance policies, and regulations to ensure compliance with industry standards and government regulations
Reporting: Generate and review accounts receivable reports, aging reports, and other billing data to ensure financial goals are met and identify areas for improvement
Collaboration: Work closely with the clinical and administrative teams to resolve any billing issues, discrepancies, or concerns

What we offer

Medical, vision, dental, and life and disability insurance
Company 401(k) plan
Access to top jobs
Competitive compensation

Fulltime

Credentialing Specialist

We are in search of a skilled Credentialing Specialist to join our team in South...

Location

United States , Southborough

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Minimum of 5 years experience as a Credentialing Specialist or a similar role in the healthcare industry
Proficiency in computerized billing systems and electronic health record (EHR) systems
Experience with Epic Software
Solid understanding and experience in accounting functions, specifically in the healthcare setting
Expertise in medical credentialing and medical billing is essential
Proficiency in Microsoft Excel
Demonstrated experience in handling various billing functions
Familiarity with contractual billing, electronic billing, healthcare billing, insurance billing, Medicaid billing, medical insurance billing, Medicare billing, patient billing, physician billing, and third-party billing

Job Responsibility

Collect, review, and validate credentials for healthcare providers, including licenses, certifications, and education
Maintain and update credentialing databases and files for all healthcare providers, ensuring all required documents are current and complete
Adhere to all applicable laws, regulations, and industry standards (e.g., NCQA, CMS, etc.) associated with credentialing
Generate and maintain reports related to credentialing status and compliance and communicate any issues or discrepancies to management
Assist with the enrollment of providers and group facilities into insurance networks and maintain active status with payer organizations
Act as a liaison between healthcare providers, insurance companies, and internal departments to resolve credentialing issues or questions
Participate in internal and external audits of credentialing files, ensuring accurate and timely completion of necessary documentation
Stay informed of changes in regulatory requirements and best practices to ensure the credentialing process remains efficient and compliant
Uphold the dignity and respect of individuals we support and ensure they are treated in accordance with our Human Rights policies
Adhere to all principles related to the Advocates Way

What we offer

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

Fulltime

Patient Financial Specialist

The associate is responsible for the duties and services that are of a support n...

Location

United States , Irving

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

HS Diploma or equivalent years of experience required
Post HS education preferred
1-3 years of experience preferred
Experience working within a multi-facility hospital business office environment preferred
College education, previous Insurance Company claims experience, and/or health care billing trade school education may be considered in lieu of formal hospital experience
Experience working with inpatient and outpatient billing requirements of UB-04 and HCFA 1500 billing forms preferred
Experience with Medicare & Medicaid billing processes and regulations preferred
Understanding of Medicare language
Knowledge in locating and referencing CMS and/or Medicare Regulations preferred

Job Responsibility

Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders
Performs Revenue Cycle functions in a manner that meets or exceeds CHRISTUS Health's key performance metrics
Ensures PFS departmental quality and productivity standards are met
Collects and provides patient and payor information to facilitate account resolution
Maintains an active working knowledge of all Government Mandated Regulations as it pertains to claims submission
Responsible to perform the necessary research in order to determine proper governmental requirements prior to claims submission
Responds to all types of account inquires through written, verbal, or electronic correspondence
Maintains payor-specific knowledge of insurance and self-pay billing and follow-up guidelines and regulations for third-party payers
Maintains working knowledge of all functions within the Revenue Cycle
Responsible for professional and effective written and verbal communication with both internal and external customers in order to resolve outstanding questions for account resolution

Fulltime

Patient Financial Specialist

The associate is responsible for the duties and services that are of a support n...

Location

United States , Irving

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

HS Diploma or equivalent years of experience required
1-3 years of experience preferred
Experience working within a multi-facility hospital business office environment preferred
College education, previous Insurance Company claims experience, and/or health care billing trade school education may be considered in lieu of formal hospital experience
Experience working with inpatient and outpatient billing requirements of UB-04 and HCFA 1500 billing forms preferred
Experience with Medicare & Medicaid billing processes and regulations preferred
Understanding of Medicare language
Knowledge in locating and referencing CMS and/or Medicare Regulations preferred

Job Responsibility

Meets expectations of the applicable OneCHRISTUS Competencies: Leader of Self, Leader of Others, or Leader of Leaders
Performs Revenue Cycle functions in a manner that meets or exceeds CHRISTUS Health's key performance metrics
Ensures PFS departmental quality and productivity standards are met
Collects and provides patient and payor information to facilitate account resolution
Maintains an active working knowledge of all Government Mandated Regulations as it pertains to claims submission
Responds to all types of account inquires through written, verbal, or electronic correspondence
Maintains payor-specific knowledge of insurance and self-pay billing and follow-up guidelines and regulations for third-party payers
Responsible for professional and effective written and verbal communication with both internal and external customers
Compliant with all CHRISTUS Health, payer, and government regulations
Exhibits a strong working knowledge of CPT, HCPCS, and ICD-10 coding regulations and guidelines

Fulltime

Provider Enrollment Specialist II - HP Enrollment Eligibility

Coordinates Medicare and Medicaid enrollment/re-enrollment and managed care cred...

Location

United States , Irving

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

High School Diploma
1-3 years of Payer Enrollment experience
Solid knowledge and utilization of PC applications to include WORD, EXCEL, ACCESS
Excellent written and verbal communication skills
Excellent organization and planning skills with demonstrated teamwork skills
Proven ability to interact with all levels of management and other Associates

Job Responsibility

Collects and maintains data on providers for Medicare and Medicaid enrollment
Prepares and submits applications to Medicare and Medicaid for new provider enrollments and existing provider updates
follows up by telephone or in writing, with carriers regarding application status
Complies with Medicare and Medicaid provider enrollment guidelines
Requests NPI numbers for providers and clinics as necessary and maintains NPI files
Follows up, either by telephone or in writing, with insurance companies and patients regarding the processing of outstanding claims and/or appeals
Generates various reports to identify outstanding claims issues with provider numbers and non-payment
Communicates information to appropriate personnel
Educates staff on corrections, e.g.. front-end entry errors in a positive, constructive manner
Collects and reviews managed care contracts for correct billing and payment terms

Fulltime

Medicaid Billing Specialist

Pafford EMS

Location:
United States

Category:
Finance

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:
December 11, 2025

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Pafford EMS

Location:United States

Category:Finance

Contract Type:Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Additional Information:

Job Posted:December 11, 2025

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