We rely on our Intake Specialist to verify key billing information entered in Point Click Care (PCC) against key billing-related information in the Medicaid Pathways portal. The role identifies differences between the Medicaid Pathways portal and PCC, reports findings to the facility and CBO Medicaid Biller, tracks discrepancies, and confirms they are resolved in a timely manner. This position also supports billing, account auditing, and Medicaid cash posting as needed.
Responsibilities
- Verify all Medicaid information entered in PCC matches information in the Medicaid Pathways portal for new Medicaid admissions.
- Prior to monthly claim submission, verify that Medicaid patient information in PCC matches the Medicaid Pathways portal.
- Provide timely written updates to the CBO Biller and Facility Business Office Manager regarding discrepancies.
- Track differences between PCC and the Medicaid Pathways portal and ensure timely resolution.
- Escalate unresolved discrepancies not corrected within 15 days to the Director of the CBO.
- Identify and report habitual Medicaid intake process issues to the Director of the CBO.
- Assist with billing, payment reconciliation, and Medicaid cash posting as needed.
- Help maintain Medicaid DSO at the company-established level.
- Perform other duties as assigned by the supervisor.
Requirements & Qualifications
Qualifications
- High school diploma or equivalent required; some college preferred.
- 4–8 years of long-term care billing experience or other healthcare accounts receivable experience.
- Ability to maintain regular attendance.
- General knowledge of payer plan and product reimbursement methodology.
- General knowledge of payer-specific filing limits, adjusted claim filing limits, and clean claim submission requirements.
- General knowledge of managed care and managed Medicaid contract terms, including participating/non-participating status, reimbursement terms, and payment methodology.
- Some understanding of payer-specific coding edits.
- General knowledge of payer portals such as Availity, UHC, Humana, and Anthem.
- General understanding of payer remittance advice/EOB details, including payments, denials, and copays.
Benefits & Perks
Benefits and Perks
- Competitive pay
- Excellent health benefits packages
- Career advancement opportunities
- Education reimbursement up to $7,500 per year
- No waiting period for enrollment
- Three health plan options
- Delta Dental
- VSP Vision
- Free basic life insurance
- Disability, critical illness, accident, and legal coverage
- 401(k) retirement plan
- Employee assistance program
Location
Indianapolis, Indiana, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
No
Posted
3 weeks ago