Experienced Data Entry Representative – Medicaid Billing and Revenue Cycle Management

Are you a detail-oriented and organized individual with a passion for data entry and revenue cycle management? Do you thrive in fast-paced environments and enjoy working closely with cross-functional teams to drive business results? If so, we invite you to join blithequark's dynamic team as an Experienced Data Entry Representative – Medicaid Billing and Revenue Cycle Management. At blithequark, we are committed to delivering exceptional patient care and services while maintaining a strong focus on revenue cycle management. As a key member of our team, you will play a critical role in ensuring timely and accurate billing of Medicaid claims for Nursing Home and Hospital services. Your expertise in data entry, attention to detail, and ability to work effectively with various stakeholders will be instrumental in driving business success and improving patient outcomes. Key Responsibilities: As an Experienced Data Entry Representative – Medicaid Billing and Revenue Cycle Management, your primary responsibilities will include:

Essential Functions:

* Billing of all Medicaid claims via the SSI software (and when appropriate web portal or paper billing), including editing billing data and reconciling all bills via KNS. * Follow up on all outstanding claims greater than 30 days, ensuring successful resolution in a timely and cost-effective manner. * Run all A/R aging reports after KNS month end to utilize as an A/R management tool. * Complete A/R spreadsheets and be prepared to review details with management at scheduled monthly review meetings. * Ongoing management of detailed A/R trial balance for Medicaid/Medicaid MMC/MMA payers to ensure proper timeliness of billing claims, appropriate documentation (i.e., authorizations, NOCA's, etc.) are received and included on claims, appeals are submitted within the appropriate timeframe, and overall compliance with all Medicaid (State) regulatory guidelines. * Follow up and facilitate resolution of all denied claims, including identifying and communicating to Director root causes and trends resulting in denials (CBO; Facility; etc.). * Obtain Medical Records from appropriate facilities for the purpose of appealing denied claims. * Ensure that most recent NOCA's are updated in the KNS database and maintained for future audits. * Maintain close working relationships with facility counterparts in business office, admissions office, case management office, medical records office, etc. to ensure effective revenue cycle management. * Utilization of all departmental system tools (i.e., KNS; Trace; SSI; etc.). Identify and communicate any and all systemic issues that may result in payment delays, underpayments, lost revenue, etc. * Billing and follow-up for Medicare co-insurance billing to Medicaid and/or Medicaid MMC/MMA payers for SNF and all other lines of business (i.e., Hospital; Outpatient and Clinics).

Other Duties:

* Perform all other duties as assigned by the Revenue Cycle Manager. * Maintain your required license, certifications, and mandatory skill updates. * Comply with all policies, local, state, and federal laws and regulations. * Perform other duties as assigned.

Supervisory Responsibility:

* No direct reports.

Physical Requirements:

* Must be able to lift and/or move up to 25 pounds and occasionally lift and/or move up to 50 pounds, walk, climb stairs or ladders, stand on feet for extended periods, etc. * Works in an office environment with moderate to loud noise level. * Subject to frequent interruptions. * Work schedule may include working beyond typical schedule, including weekends and holidays. * Hand dexterity required for data entry on keyboard, requiring finger dexterity and eye-hand coordination.

Disclaimer:

The job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee. Other duties, responsibilities, and activities may change or be assigned at any time.

EEOC Statement:

blithequark provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

Requirements:

Knowledge & Experience Requirements:

* High school diploma and two years related experience of a combination of education and training. * Must be knowledgeable with computers, calculators, system applications, spreadsheets, and other related office equipment. * Must have knowledge of computer office/clinical software. * Must be able to read, write, and understand the English language.

Salary Description:

$17.00-$20.00 If you are a motivated and detail-oriented individual with a passion for data entry and revenue cycle management, we encourage you to apply for this exciting opportunity to join blithequark's dynamic team. Apply for this job