Medical billing assistant for medicaid

Position Summary
The Medical Billing Assistant supports the primary billing staff by ensuring accurate claim reconciliation, resolving reimbursement issues, and driving timely collections. This role focuses on following up on unpaid or partially paid claims, tracking reprocessing efforts, monitoring authorization status, and reporting key performance metrics to help maximize revenue for the organization.
Key Responsibilities
Perform monthly reconciliation of claims to identify unpaid, denied, or underpaid accounts.
Investigate and resolve reimbursement discrepancies by reviewing EOBs/ERAs, payer contracts, and documentation.
Contact insurance payers (via phone, portal, or written correspondence) to determine reasons for non-payment or partial payment and take corrective action.
Follow up on partially paid claims and manage the full process required to secure complete payment (corrected claims, appeals, additional documentation, etc.).
Track and provide weekly progress updates on claims currently being reprocessed or under appeal.
Monitor and report the status of pending authorizations, ensuring timely follow-up to prevent claim delays or denials.
Calculate and report monthly collection percentages and other key billing performance metrics.
Maintain accurate notes and documentation in the billing system for all follow-up activity.
Assist with general billing support tasks as assigned by the primary billing person.
Maintain strict confidentiality of patient and financial information in compliance with HIPAA and company policies.
Required Qualifications
Previous experience in medical billing, claims follow-up, or accounts receivable (home health, long-term care, or similar preferred).
Working knowledge of insurance claim processes, denials, appeals, and common payer requirements.
Strong phone communication and problem-solving skills.
Ability to organize and prioritize a high volume of follow-up work.
Proficiency with billing software, payer portals, and Microsoft Office (Excel strongly preferred).
High attention to detail and ability to meet weekly and monthly reporting deadlines.
Preferred Qualifications
Experience with Medicaid, Medicare, or managed care claims.
Familiarity with authorization workflows and prior authorization requirements.
Experience generating collection percentage and aging reports.
This role is designed to provide dedicated support so the primary billing person can focus on higher-level billing oversight while ensuring claims are worked thoroughly and collection performance is tracked consistently.