Out-of-State Medicaid Claims Specialist

Job Summary

A company is looking for an OOS Medicaid Claims Specialist, a remote full-time role focused on Medicaid eligibility and billing processes.

Key Responsibilities

• Identify Medicaid eligibility, authorization, and documentation requirements for accounts
• Submit authorization requests and perform follow-up to ensure timely resolution
• Review and edit claims to ensure compliance with state and federal guidelines

Required Qualifications

• High School Diploma or GED
• 1-2 years of related experience in the healthcare industry preferred
• Working knowledge of ICD9, CPT codes, HIPAA, and Medicaid preferred
• Required computer skills, including data entry and MS Office applications
• Home internet connection that meets upload and download speed criteria