This position manages Medicaid billing operations, including preparing, reviewing, and submitting claims in compliance with payer requirements, ensuring services have accurate documentation and coding. It supports a hybrid work model with up to two remote days per week after training, contingent on leadership approval.
Responsibilities include monitoring claims for accuracy and timeliness, correcting denied claims, analyzing denial trends, managing provider/facility enrollment and credentialing with Medicaid and other payers, maintaining accurate provider information, researching billing and enrollment issues, ensuring compliance with Medicaid, HIPAA, and organizational policies, supporting audits and reporting, collaborating cross-functionally to enhance billing readiness, implementing process improvements, and participating in ongoing training.
The role requires interaction with insurance payers to resolve reimbursement issues and documenting billing activities to comply with regulations.
- Strong knowledge of Medicaid billing processes, regulations, and payer requirements
- Proficiency in ICD-10, CPT, and HCPCS coding systems
- Understanding of provider enrollment and credentialing processes
- Ability to analyze and resolve billing discrepancies and claim denials
- Knowledge of HIPAA compliance and healthcare privacy regulations
- Strong attention to detail and accuracy in data entry and documentation
- Effective communication skills for interaction with internal teams and external payers
- Ability to manage multiple priorities and meet deadlines in a fast-paced environment
- Associate or bachelor's degree in Healthcare Administration, Business, Finance, or related field
- Minimum 2-3 years healthcare billing experience focused on Medicaid billing
- Experience with provider enrollment and credentialing
- Preferred certifications: Certified Professional Biller (CPB), Certified Revenue Cycle Specialist (CRCS), or Certified Medical Reimbursement Specialist (CMRS)
- Prior behavioral health setting experience highly desirable
Full-Time Employee Benefits available (details via link provided in original posting).
Location
Illinois, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
Yes
Posted
1 week ago