Medicaid Coordinator I

Sarasota Memorial Health Care System•Sarasota, FL

73d•Onsite

About The Position

This position has responsibility for coordinating all Medicaid claims processing and pending Medicaid account handling. Responsible for planning, developing, evaluating and monitoring account transition from self pay to appropriate agency for financial assistance. This position serves as a bridge between financial and ICM and assists in and with communication of referral placement. This position serves as an advisor in all areas of Medicaid and pending Medicaid and has charge of timely referrals when Medicaid is denied. Responsible for keeping abreast of and complying with all Medicaid regulations. Responsible for review of Medicaid Accounts Receivable to ensure timely reimbursement of outstanding accounts receivables and analyzing Medicaid remittances to insure maximum reimbursement has been received. Responsible for resubmission of claims for additional reimbursement and/or appealing said claims with timely follow up. Responsible for maintenance of Medicaid contract manuals, communication of contracts to all departments involved and keeping abreast of all Medicaid related issues. Responds to incoming calls. Responsible for ensuring that all Medicaid claims requiring authorization are submitted for clinical review prior to billing. Fluent in the use of Passport, EQ Health, AccessANYware, Med-decision and FEMMIS.

Requirements

Require two (2) years of experience in healthcare, insurance or customer service setting.
A Bachelor's degree can be considered in lieu of the required experience.
HS EQ: High School Diploma, GED or Certificate
Require the ability to type minimum of thirty (45) words per minute.

Nice To Haves

Prefer strong interpersonal skills, including the ability to handle difficult situations in a diplomatic manner.
Prefer the ability to use commercially available software for authorization functions.
Prefer the ability to communicate effectively and with a distinct speaking voice.
Prefer working knowledge of ICD-10 and CPT coding.
Prefer previous Medicaid claims experience.

Responsibilities

Coordinating all Medicaid claims processing and pending Medicaid account handling.
Planning, developing, evaluating and monitoring account transition from self pay to appropriate agency for financial assistance.
Serving as a bridge between financial and ICM and assists in and with communication of referral placement.
Serving as an advisor in all areas of Medicaid and pending Medicaid and has charge of timely referrals when Medicaid is denied.
Keeping abreast of and complying with all Medicaid regulations.
Reviewing Medicaid Accounts Receivable to ensure timely reimbursement of outstanding accounts receivables and analyzing Medicaid remittances to insure maximum reimbursement has been received.
Resubmission of claims for additional reimbursement and/or appealing said claims with timely follow up.
Maintenance of Medicaid contract manuals, communication of contracts to all departments involved and keeping abreast of all Medicaid related issues.
Responding to incoming calls.
Ensuring that all Medicaid claims requiring authorization are submitted for clinical review prior to billing.
Fluent in the use of Passport, EQ Health, AccessANYware, Med-decision and FEMMIS.