Bus Off Medicaid Specialist at PruittHealthSanta Rosa

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Full Time

Start Date

Immediate

Expiry Date

23 Feb, 26

Salary

29.0

Posted On

25 Nov, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Medicaid Policies, Organizational Skills, Financial Operations, Billing, Collections, Compliance, Documentation, Communication, Attention to Detail, Problem Solving, Team Collaboration, Record Keeping, Customer Service, Training, Audit Assistance, Confidentiality

Industry

Hospitals and Health Care

Description

JOB PURPOSE: The Business Office Medicaid Specialist plays a crucial role in supporting the financial operations of the organization, specifically focusing on Medicaid and compliance. This position is responsible for assisting the Business Office Manager in overseeing the daily operations of the business office, ensuring accurate and timely processing of Medicaid applications, managing resident accounts, and maintaining compliance with federal and state regulations. SALARY RANGE: Minimum $22.00 to Maximum $29.00 KEY RESPONSIBILITIES: The ideal candidate will possess a strong understanding of Medicaid policies and procedures, excellent organizational skills, and a commitment to providing exceptional service to residents and their families. 1. Prepare and submit Medicaid applications in a timely manner, ensuring compliance with all relevant regulations and guidelines. 2. Review and verify the accuracy of all Medicaid documentation, including resident eligibility and financial status. 3. Monitor and follow up on outstanding Medicaid cases and denials, working diligently to resolve any issues that may arise. 4. Assist in the management of resident private pay accounts, including billing, collections, and financial reporting. 5. Ensure compliance with Medicaid regulations and guidelines, maintain up-to-date knowledge of changes in policies and procedures. 6. Assist in internal and external audits related to Medicaid, resident trust accounts and financial operations, providing necessary documentation and insights. 7. Participate in training sessions related to compliance and regulatory changes impacting the organization. 8. Serve as a point of contact for residents and families regarding Medicaid and collections related inquiries, providing clear and accurate information. 9. Collaborate with interdisciplinary teams to address resident financial needs and concerns, ensuring a high standard of service. 10. Foster positive relationships with residents, families and staff, promoting a culture of respect and compassion. 11. Maintain accurate and organized records related to Medicaid, collections and resident accounts. 12. Other duties as assigned. KNOWLEDGE, SKILLS, ABILITIES: • Participate in center/agency surveys (Licensure / JCAHO) and any subsequently required reports. • Attend and participate in continuing educational programs to keep abreast of changes in your field as well as to maintain current license/certification, as required. • Attend and participate in mandatory in-services. • Honor patients/residents’ rights to fair and equitable treatment, self-determination, individuality, privacy, property and civil rights, including the right to wage complaints. • Comply with corporate compliance program. • Report job-related functions/tasks that involve occupational hazards including exposure to blood and body fluids and others as necessary. • Follow established safety regulations, to include fire protection & prevention, smoking regulations, infection control, etc. • Follow established safety procedures when performing tasks and/or working with equipment. • Perform other related duties as necessary and as directed by supervisor. • Excellent communication and organizations skills. Proficient in Excel, Word, and e-mail. • Proven ability to work unsupervised and to prioritize and manage multiple assignments. • Remain in consistent contact with the Business Office Team to ensure seamless operational transparency to the patients and their families. • Carries out all duties with a “Commitment to Caring” and in accordance with the company’s mission, vision, and philosophy. • Maintains confidentiality of company information. • Strong work ethics are required. Ability to work in fast paced environment. • Good organizational skills. Attention to detail is essential MINIMUM EDUCATION REQUIRED: High School diploma or equivalent required MINIMUM EXPERIENCE REQUIRED: Two (2) to four (4) years’ experience in Skilled Nursing Healthcare or related field required. MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW: None ADDITIONAL QUALIFICATIONS: (Preferred qualifications) Associate’s degree preferred Billing and Financial Experience preferred Family Makes Us Stronger. Our family, your family, one family. Committed to loving, giving, and caring. United in making a difference. We are eager to connect with you! Apply Now to get started at PruittHealth! As an Equal Employment Opportunity employer, all qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, disability, or veteran status.

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Responsibilities

The Business Office Medicaid Specialist is responsible for preparing and submitting Medicaid applications, managing resident accounts, and ensuring compliance with regulations. This role also involves monitoring outstanding Medicaid cases and assisting in audits related to financial operations.