Applicants MUST live in one of the following states:
Position: Medicaid/Medicaid Advantage Follow-Up SpecialistLocation: Remote Shift: Monday - Friday, 8 AM to 5 PM PST (Flexibility available)Pay Rate: $18-20/hourOverview:We are seeking a detail-oriented and tech-savvy Medicaid/Medicaid Advantage Follow-Up Specialist. In this role, you will be responsible for managing high-volume Medicaid claims, with a focus on follow-up and correction of claims directly through payer portals. Experience with Washington State Medicaid is highly desirable, but candidates with experience in other states' Medicaid programs will also be considered.Key Responsibilities:
- Handle 0-90 day follow-up on Medicaid/Medicaid Advantage claims, including both high and low-dollar accounts.
- Manage and process in-patient and out-patient claims, ensuring all corrections are completed accurately on payer portals.
- Work closely with various Medicaid HMOs, including Coordinated Care and Molina.
- Address and remove holds on claims to facilitate timely payment processing.
- Maintain productivity standards, managing an average of 45 accounts per day.
- Perform data entry tasks with high attention to detail, ensuring accuracy and compliance with Medicaid regulations.
Qualifications:
- Must-Have:
- Experience with Medicaid Advantage and traditional Medicaid follow-up.
- Strong attention to detail and proficiency in data entry.
- Basic computer skills and ability to navigate various payer portals.
- Experience with both in-patient and out-patient claims processing.
- Ability to manage high-volume claims efficiently.
- Nice to Have:
- Experience with Washington State traditional Medicaid.
- Proficiency in Cerner (strongly preferred).
- Familiarity with Medicaid programs in other states
Apply today!