Senior Medicaid/Medicare Specialist

The primary purpose of your position is to perform accurate, timely filings of initial Medicare and Medicaid insurance claims and secondary insurance claims in accordance with DNV, Federal, State, and local standards, guidelines and regulations that govern our facility and as may be directed by the CEO and CFO to ensure that the highest degree of quality of care is maintained always.  Also, timely follow up claims not paid to assure payment to facility and maintain adequate cash flow and accounts receivable balance.

REQUIREMENTS:

• High School Diploma or GED required.
• 3 years related experience and/or training.
• Or equivalent combination of education and experience
•  At least 3-year experience in medical claim filing and vast knowledge of Medicare and Medicaid guidelines for Critical Access Hospitals.
• Basic typing skills, proper phone etiquette and computer software and electronic claims input.
• Ability to read and comprehend simple instructions, short correspondence and memos.
• Experience using the DDE (Direct Data Entry) application for Medicare claims, submissions and status on billing.
• Ability to effectively present information in one-on-one and small group situation to customers, clients, and other employees of the organization.
• Ability to add and subtract two-digit numbers and to multiply and divide by 10's and 100's. Ability to perform these operations using units of American money, weight measurement, volume and distance.
• Ability to apply common sense understanding to carry out instruction furnished in written, oral or diagram form. Ability to solve problems involving several concrete variables in standardized situations.