Billing Analyst

CommonSail Investment Group•Minneapolis, MN

3d•Onsite

About The Position

The Billing Analyst coordinates Medicaid claims submission for the company. Primary responsibilities include financial oversight of Medicaid revenue, contract negotiation, recredentialing, claims submission, monitoring outstanding receivables for both private pay and Medicaid amounts due, and working collaboratively to ensure timely payments are received.

Requirements

Bachelor’s Degree in related field preferred
2+ years of experience in Medicaid billing
Strong computer and software skills
Familiarity with Medicaid billing procedures and regulations
Excellent attention to detail and must maintain accuracy
Ability to work independently with minimal supervision and collaboratively as a team

Responsibilities

Shared financial oversight of Medicaid billings and collections
Contract negotiation
Recredentialing of MCO renewals
Assist with new community enrollments
Submit Medicaid claims monthly and investigate outstanding/denied claims
Ensure billing accuracy for dates and services rendered
Manage MCO payments and work to get 100% of claims paid through ACH vs check
Maintain digital repository of service authorization and spreadsheets to ensure accurate billing rates
Update billing system to reflect any change in daily rates
Update billing system to reflect resident days out of the community
Collaborate with community to ensure residents receive timely communication if converting to Medicaid
Proactively look for new service authorizations prior to expiration to ensure continuous claim submission and payment
Work with case manager to ensure new authorizations are received upon expiration
Maintain accurate spreadsheets of Medicaid residents, service authorization information, fees, and dates of billing
Apply Medicaid payments in billing system
Bill residents for required spend downs
Contact Medicaid providers to request information, ask questions about payments and service authorizations
Review Medicaid accounts receivable aging reports and work to resolve any denied or unpaid claims
Verify and reconcile Medicaid payments received
Work with clinical team to ensure service authorizations are consistent with care plans and provide discrepancy reporting to clinical and operations team
Assist communities with monitoring and provide reporting on residents migrating from private pay to Medicaid or other government programs
Assist with non-Medicaid accounts receivable collections processes
Assist with general accounting and financial reporting
Other duties as assigned