Medicaid / MCO Billing Specialist

About the role

We are seeking a detail-oriented and dependable Medicaid Billing Specialist to join our growing team. This position plays a vital role in managing Medicaid billing operations to ensure timely, accurate, and compliant reimbursement for patient services.

Responsibilities

• Prepare, review, and submit Medicaid claims for reimbursement in a timely and accurate manner
• Research and resolve billing discrepancies, denials, and payment issues
• Verify patient coverage and eligibility through Medicaid and other payer portals
• Ensure compliance with all Medicaid guidelines, regulations, and billing codes
• Communicate with facilities, insurance providers, and internal departments to gather missing documentation and clarify information
• Maintain detailed and organized records of all billing activity
• Monitor and track aging reports, following up on outstanding claims
• Process adjustments and corrections as needed to maintain account accuracy
• Assist with audits, reporting, and data analysis related to Medicaid billing performance
• Stay current with Medicaid billing updates and regulatory changes

Requirements

• 2+ years of experience in Medicaid billing or medical claims processing
• A strong understanding of Medicaid rules and procedures
• A high level of organization and skill in managing multiple deadlines
• A clear and professional communication style with both internal and external partners
• Proficiency in Microsoft Excel, billing software, and EHR systems (PointClickCare experience is a plus)
• Strong problem-solving skills and exceptional attention to detail
• The ability to work independently while contributing to a collaborative team environment

Qualifications

• High school diploma or equivalent
• Completion of a relevant certification program in Medicaid billing or medical claims processing preferred

Skills

• Microsoft Excel proficiency
• Billing software proficiency
• EHR systems (PointClickCare experience is a plus)

Benefits

• Comprehensive Benefits: Health, Dental, and Vision Insurance
• Extra Protection: AD&D, Short-Term Disability, Cancer, Critical Illness, and more
• Life Insurance: Whole and Term Policies
• Professional Growth: Tuition Reimbursement for continued education
• Time to Recharge: Paid Time Off
• Retirement Planning: Immediate 401(k) eligibility
• Unwavering Support: Exceptional corporate resources

Pay

Competitive salary based on experience and qualifications

Schedule

Full-time position