Medicaid Billing Specialist II

Ignite Medical Resorts•Park Ridge, IL

just now•Onsite

About The Position

Reporting directly to the Director of Central Billing, the Medicaid Billing Specialist II is responsible for managing Medicaid billing and collections with increased independence and accountability. This role ensures the accuracy of claims, adjustments, and receivables while identifying and resolving discrepancies that impact reimbursement. The Medicaid Billing Specialist II works closely with facility Business Office Managers to address eligibility and authorization issues, provides training support to Specialist I staff, and contributes to departmental performance by monitoring trends, documenting payer activity, and participating in AR reviews.

Requirements

High school diploma or G.E.D.
Minimum of three (3) years’ experience in health care insurance billing, preferably for skilled nursing facility providers.
Comprehensive knowledge of Medicaid programs, including eligibility criteria, covered services, billing rules, recipient rights and provider responsibilities
Must be able to read, write, speak, and understand the English language.
Excellent interpersonal skills
Ability to manage, analyze and reconcile billing and payment details.
Ability to work well in a team-oriented, cooperative environment.
Strong organizational skills and communication skills.

Responsibilities

Prepares and submits all Medicaid billing, turnaround documents and claim adjustments.
Communicates closely with facility Business Office Manager to ascertain status of pending applications, level of care determinations and re-certifications.
Utilizes company approved system to document and follow up on payer commitments
Identifies payment discrepancies and unpaid claims; takes appropriate action to resolve balance.
Prepares A/R adjustments and corrections as needed.
Identifies, researches and resolves credit balances according to policy and payer requirements.
Identifies adverse facility trends resulting in returned or denied claims (e.g., repeated failure to obtain prior authorization) and communicates to Business Office Manager for follow-up.
Reports status of claims and AR balances to supervisor, upon demand and/or according to established schedule and procedures.
Participates in monthly AR review.
Prepares account write-off when collection efforts exhaust and submits to supervisor.
Assists with training and orientation of Medicaid Billing Specialist I.

Benefits

GENEROUS BENEFITS PACKAGE INCLUDING HEALTH, DENTAL & VISION
401K PLAN WITH EMPLOYER MATCH
PAID TIME OFF
HOLIDAY PAY
VOLUNTARY BENEFITS - LIFE/AD&D, STD, LTD, CRITICAL ILLNESS, ACCIDENT, HOSPITAL INDEMNITY
SHORT-TERM AND LONG-TERM DISABILITY
EMPLOYEE ASSISTANCE PROGRAM (EAP)
HEALTH SAVINGS ACCOUNT (HSA)
EMPLOYER PAID LIFE INSURANCE
RASMUSSEN COLLEGE 20% DISCOUNT FOR IN PERSON CLASSES
HOSPITALITY AND TEAMWORK FOCUSED CULTURE
50% OFF IN OUR ON-SITE RESTAURANT AND LUXECAFE PROUDLY SERVING STARBUCKS
A COMMITMENT TO TECHNOLOGY
FREE PLANET FITNESS MEMBERSHIP
ON DEMAND PAY
COMPANY SPONSORED DOORDASH DELIVERY SERVICE
ADVANCEMENT OPPORTUNITIES
SUPER PERKS PROGRAM PET INSURANCE 12%-30% DISCOUNTS
SUBSIDIZED CHILD CARE BENEFITS