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Customer Service, Medicaid Specialist
In this role, you have the opportunity to
Directs Company Lifeline Medicaid telephone contacts or written inquiries to appropriate personnel while using your Medicaid and Managed care reimbursement experience . Also having the ability to answer non-technical questions regarding Company Lifeline products
Shift: 7:30 am to 4 pm
You are responsible for
Obtaining authorizations for services and enter authorization, insurance, and demographics accurately and timely.
Accurately and timely entry of CPT and diagnosis codes and the relevant authorizations to ensure clean claims are released.
Communicating proactively of billing issues.
Ensuring all claims are submitted with a goal of zero errors.
Verifing completeness and accuracy of all claims prior to submission.
Timely follow up on insurance claim denials, exceptions or exclusions.
Read and interpret insurance explanation of benefits.
Respond to inquiries from case managers, insurance companies, patients and providers and internal customers such as sales.
Regularly attend monthly staff meetings and continuing educational sessions as requested.
You are a part of
Company Lifeline Medicaid government services department based in Framingham, MA.
To succeed in this role, you should have the following skills and experience
2 plus years of Company Lifeline Medicaid experience
High School Diploma, or GED required Associates Degree in Medical Billing and Coding or Accounting, preferred. Two years of experience in lieu of education may also be considered
Computer experience is essential. Must be technically savvy and comfortable using software, including, but not limited to: billing software, MS Office, Insurance Portals, and Electronic Claims Submissions.
High aptitude to learn new programs, system integrations, and business processes
Experience in CPT and ICD-10 coding; familiarity with medical terminology
Excellent customer service skills.
Strong written and verbal communication skills
Ability to manage relationships with various Insurance payers
Experience in filing claim appeals with insurance companies to ensure maximum entitled reimbursement.
Ability to multi-task and work courteously and respectfully with fellow employees, clients and patients.
Strong work ethic with proven track record of accuracy, dependability and consistency
Must be able to think independently, have strong problem solving skills, and have a continuous improvement mentality.
Team player, ability to gain the cooperation of others in pursuit of company goals.
In return, we offer you
This is not just a job but a career for you that can help people’s lives!
Why should you join Company?
Working at Company is more than a job. It’s a calling to create a healthier society through meaningful work, focused on improving 3 billion lives a year by delivering innovative solutions across the health continuum. Our people experience a variety of unexpected moments when their lives and careers come together in meaningful ways.
To find out more about what it’s like working for Company at a personal level, visit the Working at Company page on our career website, where you can read stories from our employee blog. Once there, you can also learn about our recruitment process, or find answers to some of the frequently asked questions.
It is the policy of Company to provide equal employment and advancement opportunities to all colleagues and applicants for employment without to age, color, citizenship, disability or perceived disability, ethnicity, gender, gender identity or expression, genetic information, marital or domestic partner status, military or veteran status, national origin, pregnancy/childbirth, race, religion, sexual orientation, or any other category protected by federal, state and/or local laws. Company is an equal employment opportunity and affirmative action employer Disability/Veteran.
As an equal opportunity employer, Company is committed to a diverse workforce. In order to ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veterans' Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants that require accommodation in the job application process may contact 888-367-7223, option 5, for assistance.
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