Medicaid Insurance Follow Up Representative

Position: Medicaid/Medicaid Advantage Follow-Up Specialist
Location: Remote
Shift: Monday - Friday, 8 AM to 5 PM PST (Flexibility available)
Pay Rate: $18-20/hour

Overview:
We are seeking a detail-oriented and tech-savvy Medicaid/Medicaid Advantage Follow-Up Specialist. In this role, you will be responsible for managing high-volume Medicaid claims, with a focus on follow-up and correction of claims directly through payer portals. Experience with Washington State Medicaid is highly desirable, but candidates with experience in other states' Medicaid programs will also be considered.

Key Responsibilities:

• Handle 0-90 day follow-up on Medicaid/Medicaid Advantage claims, including both high and low-dollar accounts.
• Manage and process in-patient and out-patient claims, ensuring all corrections are completed accurately on payer portals.
• Work closely with various Medicaid HMOs, including Coordinated Care and Molina.
• Address and remove holds on claims to facilitate timely payment processing.
• Maintain productivity standards, managing an average of 45 accounts per day.
• Perform data entry tasks with high attention to detail, ensuring accuracy and compliance with Medicaid regulations.

Qualifications:

• Must-Have:

  • Experience with Medicaid Advantage and traditional Medicaid follow-up.
  • Strong attention to detail and proficiency in data entry.
  • Basic computer skills and ability to navigate various payer portals.
  • Experience with both in-patient and out-patient claims processing.
  • Ability to manage high-volume claims efficiently.

• Nice to Have:

  • Experience with Washington State traditional Medicaid.
  • Proficiency in Cerner (strongly preferred).
  • Familiarity with Medicaid programs in other states