Medicaid Billing Clerk

Public Partnerships | PPL•New York, NY

About The Position

The Medicaid Billing Clerk serves as a trusted resource for managing the revenue cycle operations that are critical to ensuring strong organizational cash flow, low denial rates, efficient denial root cause analysis, and mitigation of bad debt outcomes. This role optimizes various external and internal platforms to enhance bottom-line results and directly supports the Revenue Cycle Management Team in maintaining payer-specific revenue cycle success. Public Partnerships LLC supports individuals with disabilities or chronic illnesses and aging adults, to remain in their homes and communities and “self-direct” their own long-term home care. Our role as the nation’s largest and most experienced Financial Management Service provider is to assist those eligible Medicaid recipients to choose and pay for their own support workers and services within their state-approved personalized budget. We are appointed by states and managed healthcare organizations to better serve more of their residents and members requiring long-term care and ensure the efficient use of taxpayer funded services. Our culture attracts and rewards people who are results-oriented and strive to exceed customer expectations. We desire motivated candidates who are excited to join our fast-paced, entrepreneurial environment, and who want to make a difference in helping transform the lives of the consumers we serve.

Requirements

Knowledge of medical billing terminology.
Proficiency with medical billing and clearinghouse systems.
Strong attention to detail and organizational skills.
Excellent verbal and written communication skills.
Proficient knowledge of Microsoft Excel.
High level of data entry accuracy and speed.
Minimum of 3 years of experience in medical billing.

Nice To Haves

Related Bachelor’s degree preferred; can be substituted with 1+ years of related experience.
Experience in self-directed work environments a plus.
Relevant medical billing or coding certification preferred.

Responsibilities

Prepare and manage weekly billing activities and invoice submissions.
Prepare and re-submit corrected claims or invoices as needed.
Bill payers by inputting billing information into databases.
Appeal denied claims utilizing clearinghouse or payer portal functionality.
Reconcile billing activities between clearinghouse and host systems.
Reconcile payments and perform denial research using database queries and spreadsheet analysis.
Verify and maintain accurate receivable balances across multiple information systems.
Prepare reports based on Medicaid billing data and revenue.
Adjust patient bills by reviewing remittance advice and consulting with management.
Resolve billing discrepancies by conducting research and correcting errors.
Perform minimal business-to-business collection activity to maintain low and current receivable balances.
Follow up on delinquent payer remittances and payments.
Escalate emerging denial trends and determine root cause analyses.