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This long-term contract position involves handling various aspects of Medicaid billing for skilled nursing facilities, ensuring accuracy in claims submission and payment reconciliation. The ideal candidate will have a strong understanding of Medicaid regulations, excellent attention to detail, and the ability to communicate effectively with multiple stakeholders.
Job Responsibility:
Accurately prepare and submit Medicaid claims for skilled nursing facility residents within established deadlines
Monitor claim statuses, identify errors or rejections, and take corrective actions to ensure timely resubmission
Analyze aging reports to track outstanding balances and initiate follow-ups on unpaid or incorrectly paid claims
Reconcile payments, adjustments, and patient responsibility amounts to maintain accurate account records
Collaborate with admissions, social services, and finance teams to verify resident eligibility and payer status
Engage with Medicaid representatives and managed care organizations to resolve coverage issues and obtain prior authorizations
Maintain thorough documentation of claim statuses, correspondence, and related records
Ensure compliance with state and federal Medicaid regulations in all billing processes
Address denials by initiating appeals or reconsiderations as necessary
Provide support to facility staff and residents' families regarding billing inquiries
Requirements:
Proven experience in Medicaid billing for skilled nursing facilities
Strong knowledge of Medicaid regulations and reimbursement processes
Proficiency in medical billing software, including Epaces
Familiarity with medical coding and claims management
Ability to analyze accounts receivable and resolve payment discrepancies
Excellent organizational and documentation skills
Effective communication abilities to interact with payers, facility staff, and families
Commitment to maintaining compliance with federal and state healthcare regulations