Medicaid Specialist – Billing

Overview

Voted by Newsweek in 2024 as one of Americas Greatest Workplaces for Diversity

Early Access to Paycheck with Earned Wage Access is available for Hourly Associates (outside of CA)

Make Lives Better Including Your Own.

If you want to work in an environment where you can become your best possible self, join us! You’ll earn more than a paycheck; you can find opportunities to grow your career through professional development, as well as ongoing programs catered to your overall health and wellness.

Full suite of health insurance, life insurance and retirement plans are available and vary by employment status. Additional benefits offered include, but are not limited to:

Tuition Reimbursement

Pet Insurance

Adoption Reimbursement Benefits

Variety of Associate Discounts

Veterans, transitioning active duty military personnel, and military spouses are encouraged to apply.

To support our associates in their journey to become a U.S. citizen, Brookdale offers to advance fees for naturalization (Form N-400) application costs, up to $725, less applicable taxes and withholding, for qualified associates who have been with us for at least a year.

Responsibilities

Responsible for using established guidelines, tracking resident data, processing charges and paperwork, reconciling resident accounts, submitting billing and researching denials and payments for Medicaid State payers including Managed Care Organizations (MCO’s) for multiple states. Responds to written and verbal communications from residents, field personnel, financial/medical caseworkers and peers.

Submit monthly billing for multiple states through clearinghouse or web portals.

Review payments from state/MCO for accuracy.

Maintain authorizations for services and ensure accurate charges are reflected on accounts.

Perform accurate account research and necessary adjustments based on situation and state/MCO regulations.

Correspond with payers, communities, and/or caseworkers to correct or modify payments received.

Identify potential issues through review of daily, weekly, and monthly generated reports.

Research and assist in processing of state/MCO refunds.

Other duties as assigned based upon business need by manager/supervisor

This job description represents an overview of the responsibilities for the above referenced position. It is not intended to represent a comprehensive list of responsibilities. An associate should perform all duties as assigned by his/her supervisor.

Qualifications

Education and ExperienceHigh school diploma or general education degree (GED) required. Associate’s or Bachelor’s Degree preferred. Minimum three years experience with Assisted Living Medicaid billing including state Medicaid programs and MCO programs with an emphasis on account resolution.

Certifications, Licenses, and Other Special RequirementsNone

Management/Decision MakingMakes standard and routine decisions based on detailed guidelines with little independent judgment. Problems are generally solved with clear, detailed guidelines or by reporting them to a supervisor.

Knowledge and SkillsHas a basic level of a skill and can follow written or verbal instructions. Has basic technical skills to complete a few repetitive and well-defined duties. Has a basic knowledge of the organization in order to answer basic questions. Possesses excellent verbal and written communication skills. Proficient in Microsoft Office (Excel, Word, Outlook, etc.).

Physical Demands and Working Conditions

Standing

Walking

Sitting

Use hands and fingers to handle or feel

Reach with hands and arms

Stoop, kneel, crouch crawl

Talk or hear

Ability to lift: up to 25 pounds

Vision

Requires interaction with co-workers, residents or vendors

Brookdale is an equal opportunity employer and a drug-free workplace.

Job LocationsUS-TN-Brentwood

CategoryFinance

Sub-CategoryInsurance/Reimbursement

Position Type (Portal Searching)Regular Full-Time

ID2024-263378

Location : NameHR – Recruiting-NSH

Location : Address105 Westwood Pl

Location : LocationUS-TN-Brentwood

Job Code104620a

Work LocationRemote