Medicaid & Accounting Specialist

Description

Company Overview: 

Carey Services is a community-based organization which receives strong support from a broad cross-section of individuals, families, businesses and charitable interests. Supports and services are determined through person-centered planning, whereby individuals and their families direct the planning and allocation of resources to meet their own individual life goals.

Job Details:

Wage: $17.50/Hour, Non-exempt

Hours: Full-time

Schedule: Monday-Friday, 8:00am-4:30pm

Job Summary and Responsibilities:

The Medicaid & Accounting Specialist is responsible for ensuring accurate and timely submission, auditing, and reconciliation of Medicaid and other third-party billing claims. This position maintains detailed billing records, monitors payment activity, follows up on unpaid or denied claims, and completes billing resubmissions as needed. The specialist works closely with programming, finance, and administrative staff to ensure compliance with Medicaid regulations and agency policies, contributing to the overall financial integrity of Carey Services. 

The specialist works with the VP of Finance, assisting in coordination of billing tracking systems, software, and ancillary tracking tools to maximize the effectiveness of those systems and tools to maximize compliant Medicaid billing and collection. With Medicaid billing and collection as the specialist’s primary duty, as assigned, the specialist assists the VP of Finance with other assigned duties and tasks to help the Accounting Department to run smoothly (i.e., overall accounting tracking, property leasing and tracking, etc.).

Example Activities: 

· Audit service documentation for completeness and compliance prior to billing submission.

· Submit electronic claims through Medicaid portals and track claim status.

· Review remittance advice documentation, identify denials, and process resubmissions as needed.

· Maintain accurate billing logs and support month-end reconciliation processes.

· Follow up with program departments for missing or corrected documentation.

· Prepare reports summarizing billing activity, outstanding claims, and payment trends.

· Assist with preparation and documentation during internal and external billing audits.

· Communicate with Medicaid representatives to resolve payment or eligibility discrepancies.

Occupational Competencies

· Billing & Claims Management: Knowledge of Medicaid and third-party billing procedures, including claim creation, submission, correction, and payment posting.

· Auditing & Compliance: Ability to review billing documentation for accuracy, completeness, and compliance with state, federal, and agency guidelines.

· Records Management: Proficiency in maintaining organized, compliant, and confidential billing records in both electronic and paper formats.

· Follow-Up & Resubmission: Skilled in tracking claim status, identifying denials or errors, and performing successful follow-ups and resubmissions within required timelines.

· Accounting Principles: Understanding of basic accounting practices, reconciliations, and financial reporting.

· Technology Skills: Experience with learning and assisting with mastering billing software, Microsoft Excel, and database management systems used for Medicaid and service documentation.

Foundational Competencies 

· Attention to Detail: High level of accuracy and precision in reviewing financial data and documentation.

· Analytical Thinking: Ability to identify issues, interpret data trends, and propose solutions to reduce billing errors.

· Communication: Clear and professional communication with internal departments, external payers, and auditors.

· Time Management: Ability to manage multiple billing cycles and meet strict submission deadlines.

· Ethical Practices: Commitment to confidentiality, integrity, and adherence to Medicaid, HIPAA, agency, and other regulatory standards and requirements.

· Team Collaboration: Works effectively with cross-departmental teams to resolve billing discrepancies and improving pro