Medicaid Analyst Customer Service
Every day is an opportunity for our associates to deeply connect with people in a profound and personal way. Our associates are the core of our mission and we know that offering them genuine rewards and heart filling job satisfaction is the key to our success as a company. Here you’ll find opportunities to grow your career at any level whether you have direct contact with resident or support someone who does, and be inspired personally. With over 60,000 associates, there’s a place for you to make a difference in lives of the families we serve throughout our continuum of care.
Responsible for using established guidelines, tracking resident data, processing charges and paperwork, reconciling resident accounts, submitting billing and researching denials and payments for Medicaid State payers including Managed Care Organizations (MCO’s) for multiple states. Responds to written and verbal communications from residents, field personnel, financial/medical caseworkers and peers.
- Performs adjustments to the resident accounts based on census, cost share and rates. Maintains resident database for tracking authorizations, client obligations and charges.
- Submits monthly billing for multiple states through clearinghouse or web portals.
- Reviews payments from State and MCO’s for accuracy; corresponds with payers, communities and caseworkers to correct or modify payments received. Identifies potential issues through review of daily, weekly, and monthly generated reports.
- Researches and processes refunds for Medicaid residents, State and MCO’s.
- Researches, communicates and responds to inquiries from residents, family members, field staff and other departments.
This job description represents an overview of the responsibilities for the above referenced position. It is not intended to represent a comprehensive list of responsibilities. An associate should perform all duties as assigned by his/her supervisor.
Education and Experience
High school diploma or general education degree (GED) required. Associate’s or Bachelor’s Degree preferred. Minimum three years experience with Assisted Living Medicaid billing including state Medicaid programs and MCO programs with an emphasis on account resolution.
Certifications, Licenses, and Other Special Requirements
Makes standard and routine decisions based on detailed guidelines with little independent judgment. Problems are generally solved with clear, detailed guidelines or by reporting them to a supervisor.
Knowledge and Skills
Has a basic level of a skill and can follow written or verbal instructions. Has basic technical skills to complete a few repetitive and well-defined duties. Has a basic knowledge of the organization in order to answer basic questions. Possesses excellent verbal and written communication skills. Proficient in Microsoft Office (Excel, Word, Outlook, etc.).
Physical Demands and Working Conditions
- Use hands and fingers to handle or feel
- Reach with hands and arms
- Stoop, kneel, crouch crawl
- Talk or hear
- Ability to lift: up to 25 pounds
- Requires interaction with co-workers, residents or vendors
Brookdale is an equal opportunity employer and a drug-free workplace.