Managed Medicaid Specialist

The Medicaid Managed Care Specialist reviews, investigates, and follows up on insurance claims. This role supports claims processing, payment tracking, appeals, collections follow-up, and communication with customers and internal teams.

Key responsibilities include:

• Ensure established accounting procedures are followed for processing insurance claims
• Check information accuracy for claim submission
• Monitor claims processing status, recorded payments, and adjustments within the billing system
• Maintain accurate records and up-to-date billing systems
• Manage and submit appeals, calls, emails, and other efforts to obtain insurance coverage payment
• Follow up on, collect, and allocate payments as applicable
• Perform collections follow-up in accordance with established procedures
• Research and resolve denied claims in a timely manner
• Investigate and resolve customer queries via phone, email, mail, or in person
• Assist with monthly statements as requested by supervisor
• Perform other duties as assigned