Reimbursement Specialist

Our Reimbursement Specialists are responsible for researching and filing accurate Medicaid claims. Claims and billing experience valued but training will be provided, when needed. This is a full-time position and benefits include:

• Health insurance
• Health Savings Account w/company contribution
• Dental, Vision and Life insurance
• Nine paid holidays annually
• Paid vacation and sick time off
• Paid volunteer time off
• 401k with company match
• And more

PRIMARY RESPONSIBILITIES:

• Research Medicaid claims and achieve resolution. This may include researching the Medicaid system and/or our Client’s system.
• Research Medicaid claims until payment has been received in full or until account has to be returned.
• Research and record progress in ClaimAid’s system (CTS) and our Client’s system.
• Request necessary documentation from outside sources to properly adjudicate claim.
• Accurate filing of all necessary documentation.
• Respond to client’s inquiries pertaining to claims.
• Maintain confidentiality of patient health information in compliance with HIPAA regulations.

QUALIFICATIONS:

• Valued - Knowledge of ICD-10 and CPT coding. Multi-line claims experience a plus, including knowledge of UB04 and CMS1500.
• Valued - Knowledge of Indiana Medicaid Portal, including all Managed Care payer portals for correcting claims and checking eligibility.
• Valued - Past experience in office administration, supply chain administration, etc.; any experience that requires strong organizational and time management skills
• Required - Strong investigative, analytical and judgment skills.
• Required - Excellent spelling and grammar; phone skills; basic math skills; ability to multi-task; must carefully proof own work.
• Required - Effective communication skills to convey information accurately, listen effectively, and ask questions when clarification is needed.
• Required - Must be able to work independently and as part of a team.
• Required - Professional demeanor both on the phone and in person.
• Required - High school diploma required.

PHYSICAL REQUIREMENTS:

• Hearing: Adequate to perform job duties in person and over the telephone.
• Speaking: Must be able to communicate clearly in person and over the telephone.
• Vision: Visual acuity adequate to perform job duties, including reading information from printed sources and computer screens.
• Requires frequent bending, standing, walking (sometimes at a fast pace and for long periods of time), squatting and sitting.

The above is intended to describe the general content and requirements for the performance of this position. It is not to be construed as an exhaustive statement of duties, responsibilities, or requirements.

Job Type: Full-time