Medicaid Billing Specialist

Job Summary 

The Medicaid Billing Specialist must be well organized and dedicated to maintaining the fiscal integrity of ICM. This position is responsible for performing customer set up in ICM’s EHR system, ensuring all billing documentation is accurately recorded in all ICM systems, manually billing customer payors, electronically billing payers, completing claim analysis, working claim collections, and assisting with other billing functions as needed. As a company dedicated to providing services to individuals with disabilities, ICM is committed to ensuring that our financial operations are accurate, efficient, and in line with the values of care and service that guide our work.  

Primary Duties and Responsibilities  

The responsibilities described below may not reflect all duties asked of this position but rather indicate categories of work. Duties will include, but will not be limited to the following: 
 

• Plan Authorization Management:  

• Review, verify and process all PA requests.  

• Review and maintain a list of all expiring PA’s, effectively communicating with operations team regarding expiring PA’s.  

• Maintain Customers in Therap:  

• Create all customers in Therap, ensuring customer configuration is accurate in accordance with billing requirements.  

• Enroll, discharge, and maintain customers and customer information in Therap.  

• Create customer caseloads in Therap. 

• Maintain accurate records of customer information in Therap. 

• Eligibility:  

• Monitor customer eligibility on a weekly basis, notify and work with operations department to ensure no lapse in eligibility.  

• Billing and Reporting:  

• Complete all manual billing 

• Perform electronic billing.  

• Accurately bill all Autism supplies, reimbursable mileage billing, OHCDS expenses, and therapist billing.  

• Organizes and maintains source documentation such as invoices, expense reports, etc. 

• Responsible for weekly and monthly billing reports as assigned.  

• Other Duties will include:  

• Assists with audit requests. 

• The position assists in keeping the agency compliant with all laws, rules and regulations. 

• Completes various ad-hoc requests from the Controller and CFO. 

• Cross trains with other Finance Department team member roles. 

• Other duties as assigned by the Controller and CFO 

Key Competencies 

• Strong ethical standards 

• Detail oriented and analytical. 

• Ability to plan, execute, and meet deadlines. 

• Strong communication skills to effectively interact with team members, management, and outside parties. 

• Knowledge of computer fundamentals and business software including database, spreadsheets, and word processing software.  

• Proficient with Microsoft office, specifically Microsoft Excel  

• Ability to work with sensitive information and to maintain confidentiality. 

• Ability to identify billing issues and problem solve to resolve billing discrepancies. 

• Ability to research, learn, interpret, and apply rules, regulations and policies pertaining to billing and services. 

General Requirements for All ICM Employees  

• Understands and endorses ICM’s mission and vision 

• Follows all ICM policies and procedures and asks for clarification and explanation when needed 

• Understands and complies with all HIPAA regulations 

• Maintains a clean and orderly work environment 

• Maintains prompt and regular attendance. 

Qualifications/Specifications 

Education (preferred):  Two (2) years of college or vocational technical school course work in Business Administration, or a related area; Bachelor’s degree in Business Administration or a related field such as Business Administration or Finance preferred 

 Experience: Minimum of 6 months of experience in billing processing, or related area. Medicaid billing experience preferred, but not required. 

 Essential Technical/Motor Skills: Ability to perform tasks efficiently.  Able to type and use computer efficiently.  Able to operate various office equipment such as copier, multi-line phone system, and fax machine.  

 Interpersonal Skills: Must be able to successfully interact and communicate with all levels of staff, clients, and customers in an effective manner exhibiting tact, enthusiasm, and patience.  Must be a self-motivator with ability to take ownership of job responsibilities.  Must have strong organizational skills.   

 Essential Physical Requirements: Requires full range of body motion including sitting, standing, handling and lifting, manual and finger dexterity, and hand-eye coordination.  Able to lift and carry items up to 25 pounds.  

 Critical Cognitive Abilities: Requires excellent communication and organizational skills.  Requires reasoning ability, use of independent judgment, and discretion.  Able to demonstrate competence in project management and time management. Requires work with frequent interruptions.    

Work Schedule 

Primarily, the days and hours will be Monday – Friday 8 am to 4 pm. Weekends and evenings as needed if emergencies arise. Hours and workdays will vary to accommodate the needs of the customer and ICM. ICM permits a hybrid approach to working remotely and in-office, as approved by the supervisor. This position would allow a hybrid approach of 2-3 remote days per week, on a flexible basis, based on employee supervisor preference.