Role OverviewThe Intake Specialist verifies key billing information in PCC and Medicaid Pathways portal, identifies differences, and reports findings to facility and CBO Medicaid Biller. They track differences and confirm resolutions are timely. They assist with billing, auditing accounts, and Medicaid cash posting as needed.
What You Will Do
Verify Medicaid information in PCC matches information in Medicaid Pathways portal for new admissions and prior to monthly claim submission. Provide written information to CBO Biller and facility Business Office Manager of differences noted. Track differences and ensure resolutions are timely. Escalate unresolved differences to the Director of the CBO.
Why It Might Be a Fit
This role requires a high school diploma or equivalent, 4-8 years of LTC billing experience, and general knowledge of payer plan/product reimbursement methodology, payer specific filing limits, and managed care contract terms.
Requirements
- High School Diploma or equivalent
- 4-8 years of LTC billing experience or other AR healthcare related experience
- General knowledge of payer plan/product reimbursement methodology
- General knowledge of payer specific filing limits, adjusted claim filing limits and requirements of clean claim submission
- General knowledge of managed care and managed Medicaid contract terms
- Some understanding of payer specific coding edits
- General knowledge of payer portals (Availity; UHC, Humana, Anthem)
- General understanding of payer remits/EOB's details (payments, denials, copays, etc.)
Benefits
- Competitive Pay
- Excellent health benefits packages
- Career advancement opportunities
- Education reimbursement program of up to $7,500 per year
- No waiting period for enrollment
- Three health plan options
- Delta Dental
- VSP Vision
- Free Basic Life Insurance
- Disability, Critical Illness, Accident & Legal Coverage
- 401(k) Retirement Plan
- Employee Assistance Program
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