Reimbursement Specialist

Lavalette, WV 25535, United States

Job Description


The main job duties of the Reimbursement Specialist include, but are not limited to:

  • Gather all consumer budgets to reflect the current budgeted services per consumer.
  • Creation and upkeep of Individual Provider Plan (IPP) and review dates for all consumers.
  • If there are any inconsistencies to report they must be reported to the Clinical Director and Executive Director
  • Utilization of units to Case Manager before each Annual IPP
  • Assist Billing Specialist
  • Resubmit all denied billing.
  • Enter Medicaid billing into the WVMMIS/ Molina web portal.
  • Creation and upkeep of a comparison sheet for billing for upkeep of units re-billable, paid, and denied units.
  • Assist with enter Medicaid billing into the WVMMIS/ Molina web portal.
  • Assist with preparing documentation for billing
  • Utilize Remittance advice to track units and determine claim status
  • Find appropriate solutions to present and positively resolve issues in unit tracking and pended or denied claims.
  • Actively work with DXC Technology (Molina), Kepro, and other agencies to ensure billing is submitted without issues and payment is received.
  • If a long-term absence of either the Billing Data Specialist or Billing Specialist it will be the responsibility to fulfill the job duties until the role is filled.
  • Must be able to develop and use Microsoft Office programs.
  • Good math skills are essential.
  • Employee must be detail oriented.
  • Employee must be organized.
  • Teamwork is crucial
  • This position is for 40 hours a week.
This job description is not all inclusive of the duties that maybe assigned to this specific job, new assignments may be given as deemed necessary by a member of the Management Team. Supervisors: Jayne Lakes, Executive Director Job Type: Full-time Pay: From $13.00 per hour Expected hours: 40 per week Benefits:
  • Dental insurance
  • Health insurance
  • Life insurance
  • Paid time off
  • Vision insurance
Schedule:
  • 8 hour shift
  • Day shift
  • Monday to Friday
Work setting:
  • Office
Ability to commute/relocate:
  • Lavalette, WV 25535: Reliably commute or planning to relocate before starting work (Required)
Work Location: In person

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Job Detail

  • Job Id
    JD4353538
  • Industry
    Not mentioned
  • Total Positions
    1
  • Job Type:
    Full Time
  • Salary:
    Not mentioned
  • Employment Status
    Permanent
  • Job Location
    Lavalette, WV 25535, United States
  • Education
    Not mentioned