Posted Nov 20
This employer requests that only candidates within 100 miles of Cincinnati, OH apply to this job.
You appear to be located near Ashburn, VA, more than 100 miles from Cincinnati, OH.
Please be aware of this if you choose to apply for this job.
Job Title: Medicaid Manager
Relocation Available: No
Location: Cincinnati, Ohio
Job Type: Permanent full-time
Position Summary: Primarily responsible leadership and management of the Medicaid Department.
General Purpose: Leadership; problem resolution; critical thinking; auditing; relationship and team building; process development and improvement
Essential Duties and Responsibilities:
• Work with Human Resources staff to recruit, interview, select and hire for the Medicaid Department.
• Coach, mentor and develop staff, including overseeing new employee onboarding and providing development and education opportunities for the Medicaid Department.
• Lead employees to meet the organization's expectations for productivity, quality, and goal achievement.
• Plan and allocate resources to appropriately staff each assignment.
• Evaluate and improve departmental operating procedures to enhance speed, quality, efficiency and financial results.
• Review performance data to monitor and measure departmental productivity, goal achievement, and overall effectiveness.
• Review insurance contracts and Medicaid Provider Manuals to gain thorough understanding of payment methodologies.
• Examine claims and calculate reimbursement based on contract terms to determine accuracy of payment through use of various reports, electronic tools and supporting documentation.
• Contact insurance company to obtain missing information, explain and resolve underpayments and/or denials and arrange for payment or adjustment processing on behalf of client.
• Prepare and submit correspondence such as letters, emails, online inquiries, appeals, adjustments, reports and payment posting.
• Maintain regular contact with necessary parties regarding project status including payors, clients, managers, and other company personnel.
• Build strong, lasting relationships with clients, payors and company personnel.
• Organize, prepare and/or attend department, client and company meetings.
• Comply with federal and state laws, company policies and procedures.
Essential Skills and Experience:
• Minimum 5-years Management experience
• Minimum 2-years Healthcare related experience
• Excellent interpersonal skills with proven ability to motivate and lead a team