Medicaid Analyst

Job Description

Job Description

Medicaid Analyst

Full-time - Allentown, PA

Phoebe Ministries is hiring a Medicaid Analyst to join our long-term care facility in Allentown, PA.

We show our employees our appreciation for their contribution towards carrying out our mission of enriching the lives of seniors.

Phoebe Allentown has a beautiful, updated campus and high standards of excellence for all our employees.

Phoebe offers great PERKS and BENEFITS :

• Generous Paid Annual Leave Time PLUS the ability to sell back unused time twice a year!!!
• Full Benefit Package, including Health, Dental, Vision and Life Insurance.
• Tuition Reimbursement.
• Service Awards & Recognition Gift Cards.

Responsibilities for a Medicaid Analyst with Phoebe Allentown :

The Medicaid Analyst will be responsible for entering PA162’s / MA Approvals for Medicaid Fee for Service and Community Health Choices MA products into the Billing System upon receipt and will manage census line entries to ensure accurate billing.

The Analyst will conduct audits and will validate Resident medical expenses and insurance premiums that are submitted to Medicaid as part of the monthly billing cycle.

Responsible for the submission of monthly claims and any claim adjustments that may be required based on Medicaid protocols to adjudicate claims.

The Medicaid analyst will review, prepare, and submit responses to any Community Health Choices Claim Audit(s). The Analyst will be responsible for the submission of all 180-day exception unit claims.

Payments associated with Medicaid will require accurate posting to Resident accounts and the Medicaid Receivable must be managed closely minimize days in AR.

The Analyst will update quarterly rates in PCC and will be responsible for managing and responding to CHC Quality Improvement Program monthly data requirements.

Effective management of the receivable and reporting of current trends that impact the Medicaid receivable will be required.

Requirements for a Medicaid Analyst with Phoebe Allentown :

• Degree or some course work in Business Administration or related course of study preferred.
• Minimum three years experience in related positions required.
• Experience in medical claims billing / coding; experience with insurance follow-up processes / procedures ; experience working for a medical insurance company.
• Successful candidates are those who thrive in a positive and respectful Customer Driven Culture and exemplify the organization’s Faith in Action Mission, Vision, and Values.

Phoebe Ministries is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

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