Medicaid Billing Specialist

Job Title: Medicaid Billing SpecialistWork Location: Pafford Medical Services, Inc. – Corporate OfficeDivision/Department: PMBSReports To: Team Lead Full-Time NonexemptJob Description:Pafford Medical Services is seeking a detail-oriented and experienced Medicaid Billing Specialist / Follow Up Specialist to join our team. This role is crucial in ensuring the timely and accurate processing of Medicaid claims and follow-up activities. The ideal candidate will have a strong background in medical billing, particularly with Medicaid, and be adept at resolving claim issues and discrepancies.Essential Duties and Responsibilities:- Medicaid Billing:- Accurately prepare and submit Medicaid claims for services rendered by Pafford EMS.- Ensure all claims are coded correctly and comply with Medicaid regulations and guidelines.- Monitor and verify patient eligibility and insurance coverage.- Follow-Up and Claim Resolution:- Conduct follow-up on outstanding claims and ensure timely resolution of billing issues.- Communicate with Medicaid offices, patients, and other relevant parties to resolve claim discrepancies, denials, or rejections.- Review and appeal denied claims, providing necessary documentation and information.- Record Keeping and Reporting:- Maintain accurate and up-to-date records of billing activities, payments, and follow-ups.- Generate regular reports on billing status, outstanding claims, and payment trends.- Compliance and Continuous Improvement:- Stay informed about changes in Medicaid regulations and billing procedures.- Participate in training and development opportunities to enhance knowledge and skills.- Recommend and implement process improvements to enhance billing efficiency and accuracy.Qualifications:- Minimum of 2-3 years of experience in medical billing, with a focus on Medicaid billing and follow-up.- In-depth knowledge of Medicaid regulations, coding (ICD-10, CPT), and billing procedures.- Experience with medical billing software and electronic health records (EHR) systems.- Strong analytical and problem-solving abilities.- Excellent attention to detail and accuracy.- Effective communication and interpersonal skills.- Ability to work independently and manage multiple tasks.- Proficiency in Microsoft Office Suite (Word, Excel)Education and Experience Requirements: High School Diploma or GED Minimum of 2-3 years revenue cycle management experiencePhysical Requirements: Ability to safely and successfully perform the essential job functions consistent with the ADA, FMLA and other federal, state and local standards, including meeting qualitative and/or quantitative productivity standards. Ability to maintain regular, punctual attendance consistent with the ADA, FMLA and other federal, state and local standards. The employee may occasionally be required to lift and/or move up to 20 pounds Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. Work may require sitting, lifting, stooping, bending, stretching, walking, standing, pushing, pulling, reaching, and other physical exertion. Must be able to talk, listen and speak clearly on telephone. Must possess visual acuity to prepare and analyze data and figures, operate a computer terminal, and operate a motor vehicle.Travel Time: Negligible