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Medicaid Billing Specialist (Temporary)

Medicaid Billing Specialist (Temporary)

AAMA Sanchez Charter SchoolHouston, TX, United States
10 hours ago
Job type
  • Full-time
Job description

BASIC FUNCTION : Possess and apply thorough knowledge to all aspects of program billing processes including eligibility, coding, and insurance / payer requirements. Also responsible for accurate and timely grant and other billings and reports as assigned. This is a TEMPORARY Full Time Position. Approx 11 / 2025 thru 3 / 2026

MINIMUM QUALIFICATIONS :

  • Experience and knowledgeable on governmental payers Medicare and Medicaid dealing with Substance Use Disorders.
  • Knowledgeable on the credentialing and recredentialing processes
  • Knowledgeable on insurance billing, collections, and reimbursement processes
  • High school diploma or GED required
  • Basic accounting skills, knowledge of Excel and other Microsoft Office products.
  • Must be available to work Monday-Friday, standard business hours

PRINCIPAL ACCOUNTABILITIES :

  • Ensures claim information is complete and accurate by reviewing claims for discrepancies
  • Identify potential issues as it relates to coding or insurance requirements and when needed, works with the proper staff member to correct errors
  • Monitor claim submission statistics via generated reports
  • Follows up with insurance companies on unpaid or rejected claims to determine and resolve any outstanding issues and re-submit corrected claims if necessary
  • Investigate, verify, and analyze patient's eligibility results for any medical coverage and obtain proper billing contact information
  • Request or obtain documentation where applicable
  • Enters information necessary for insurance claims such as client, insurance, provider, as well as diagnosis recommended by LCDC, Licensed Chemical Dependency Counselor, treatment codes and modifiers if applicable.
  • Submits insurance claims to clearinghouse or individual insurance companies electronically or via paper
  • For clients with coverage by more than one insurer, prepares and submits secondary claims upon processing by primary payer
  • Follows HIPAA guidelines in handling patient information
  • Contact providers for credentialing and credentialing applications, gather and submit required documentation for credentialing.
  • Verify with the insurance company that the credentialing application was received, and follow up with the insurance network on a regular basis until your credentialing is complete and you have a network effective date with a participating provider agreement
  • Respond to any requests for additional information that the insurance company may have
  • Document all of your follow up activities as you go through the credentialing process
  • Review your participating provider contract for details of your requirements as a network provider, claims submission procedures, fee schedule for your services, timely filing limits, and all other important contract terms
  • Keep copies of all credentialing applications and contracts submitted. Retain a final copy of any network contracts
  • Generate reports for Director
  • Performs other duties as assigned.
  • Other Skills / Experiences :

  • Strong organizational skills and attention to detail
  • Excellent written and verbal communication skills
  • Ability to work independently with minimal direction and oversight as well as with a team
  • Ability to handle multiple responsibilities under strict deadlines and prioritize efficiently
  • Familiarity with HIPAA privacy guidelines and maintains and protects all confidential information
  • PHYSICAL AND MENTAL REQUIREMENTS : Prolonged periods of using a computer and sitting at a desk. Ability to review and analyze data and effectively communicate with internal and external customers.

    WORK ENVIRONMENT : Office

    OCCUPATIONAL EXPOSURE CATEGORY : Minimal

    WORK SCHEDULE : This position is non-exempt and is eligible for overtime. Typical hours are Mon -Friday 8-5. On occasion may be asked to participate in special events that may occur on the weekend or in the evenings.

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    Billing Specialist • Houston, TX, United States

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