Job Description

The main job duties of the Reimbursement Specialist include, but are not limited to:

• Gather all consumer budgets to reflect the current budgeted services per consumer.
• Creation and upkeep of Individual Provider Plan (IPP) and review dates for all consumers.
• If there are any inconsistencies to report they must be reported to the Clinical Director and Executive Director
• Utilization of units to Case Manager before each Annual IPP
• Assist Billing Specialist
• Resubmit all denied billing.
• Enter Medicaid billing into the WVMMIS/ Molina web portal.
• Creation and upkeep of a comparison sheet for billing for upkeep of units re-billable, paid, and denied units.
• Assist with enter Medicaid billing into the WVMMIS/ Molina web portal.
• Assist with preparing documentation for billing
• Utilize Remittance advice to track units and determine claim status
• Find appropriate solutions to present and positively resolve issues in unit tracking and pended or denied claims.
• Actively work with DXC Technology (Molina), Kepro, and other agencies to ensure billing is submitted without issues and payment is received.
• If a long-term absence of either the Billing Data Specialist or Billing Specialist it will be the responsibility to fulfill the job duties until the role is filled.
• Must be able to develop and use Microsoft Office programs.
• Good math skills are essential.
• Employee must be detail oriented.
• Employee must be organized.
• Teamwork is crucial
• This position is for 40 hours a week.

This job description is not all inclusive of the duties that maybe assigned to this specific job, new assignments may be given as deemed necessary by a member of the Management Team. Supervisors: Jayne Lakes, Executive Director Job Type: Full-time Pay: From $13.00 per hour Expected hours: 40 per week Benefits:

• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Work setting:

• Office

Ability to commute/relocate:

• Lavalette, WV 25535: Reliably commute or planning to relocate before starting work (Required)

Work Location: In person