Medicaid Billing and Collection Specialist

Northside Hospital is award-winning, state-of-the-art, and continually growing. Constantly expanding the quality and reach of our care to our patients and communities creates even more opportunity for the best healthcare professionals in Atlanta and beyond. Discover all the possibilities of a career at Northside today.

OCCUPATIONAL SUMMARY

Bills and collects on hospital Medicaid/CMO accounts in a timely and accurate manner.

PRIMARY DUTIES AND RESPONSIBILITIES

1. Prepares standardized, uniform, or customized hospital claim forms to all Medicaid and CMO carriers in a timely and accurate manner.
2. Maintains current status in billing daily downloads as well as completing referrals, late charges and returned claims from coding and audit accurately and within the required timeframe.
3. Maintains current working knowledge of universal hospital billing regulations and requirements as well as individual Northside Hospital
4. Maintains current status in ATB as well as completing collections referrals accurately and within the required timeframe.
5. Maintains monthly collection goal minimum standards of 95%.
6. Prepares daily, weekly, and monthly production reports by the required deadline.
7. Takes the initiative to solve problems and inquiries on individual accounts; referring serious problems to lead or Supervisor.
8. Reviews and prepares UB04 hospital claim forms for submission to Medicare, CMO, and Champus in a timely and accurate manner.
9. Maintains current status with daily billing download as well as all secondary claims, cross-over forms and referrals from other departments.
10. Reviews, corrects and follows up on all Medicaid claims via the Web Portal or CMO websites maintaining an acceptable status.
11. Maintains a current working knowledge of all changes in hospital billing guidelines and regulations for Medicaid, CMO and Champus.
12. Works with other departments to resolve billing issues and ensure compliance with all Government regulations.
13. Practices proper safety techniques in accordance with hospital and departmental policies and procedures. Immediately reports any mechanical or electrical equipment malfunctions, unsafe conditions, or employee/patient/visitor injury‑accident to Manager.

KNOWLEDGE SKILLS AND ABILITIES/LICENSE OR CERTIFICATION REQUIRED

1. One (1) year experience in hospital Medicaid/CMO billing or collections, OR Associate's Degree in Business.
2. Good verbal communication skills, and basic typing ability.

KNOWLEDGE SKILLS AND ABILITIES/LICENSE OR CERTIFICATION PREFERRED

1. B.S. degree in Business or Accounting.
2. Two (2) years experience in hospital Medicaid/CMO billing or collections.
3. Prior hospital business office collections.
4. Demonstrated knowledge of hospital electronic billing systems.