Medicaid Managed Care Specialist SUMMARY:The Medicaid managed Care Specialist works to review, investigate and follow-up on various insurance claims.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Ensure that established accounting procedures are followed for processing insurance claims


• Checking for accuracy of information for claim submission.


• Monitoring claims processing status, recorded payments and adjustments within the billing system.


• Maintain accurate records, up to date billing systems


• Managing and submitting appeals, calls, emails and other efforts to obtain insurance coverage payment.


• Follow-up on, collect and allocate payments as applicable


• Performing collections follow-up process in accordance with established procedures.


• Research and Resolve denied claims in a timely fashion

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