Medicaid Billing Specialist

The Utah Department of Health and Human Services seeks a Financial Analyst III-Medicaid Billing Specialist to be responsible for managing and processing Medicaid claims related to services provided under the Utah 1115 waiver at the Division of Juvenile Justice and Youth Services. This role will involve collaborating with healthcare providers, JJYS personnel, and other agencies to ensure accurate billing, compliance with Medicaid regulations, and maximizing reimbursement for services rendered.

Roles and Responsibilities

• Prepare, submit and monitor claims for Medicaid reimbursements via Prism for Juvenile Justice and Youth Services.
• Ensure compliance with federal and state Medicaid regulations, including the specifics of the Utah 1115 waiver.
• Accurately enter and maintain billing data in the electronic medical record (EMR) and billing systems.
• Review patient records and service documentation to verify appropriateness for billing and compliance with Medicaid guidelines.
• Work closely with service providers, case managers, and the finance department to resolve billing discrepancies and improve processes.
• Provide training and support to staff regarding billing procedures and changes in Medicaid policies.
• Assist in generating reports for management, detailing billing outcomes, revenue cycles, and compliance metrics.
• Other duties will be assigned as needed.

Minimum Requirements

• Has basic accounting experience.
• Experience in medical billing, specifically with Medicaid.
• Proficiency in Medicaid billing software and healthcare management systems.
• Strong attention to detail and excellent organizational skills.
• Understanding of JJYS operations and the Utah 1115 waiver initiatives
• Has basic knowledge and experience with computer programs such as Excel, Word, and Access.
• It is detail oriented.

Our Agency

The Department of Health and Human Services is dedicated to providing care for individuals and families in Utah. Utah Division of Juvenile Justice and Youth Services (JJYS) provides a continuum of prevention, intervention, supervision and rehabilitation services and programs to youth offenders while assuring public safety. For more information on Juvenile Justice and Youth Services with the Department of Health and Human Services, please click here!

Supplemental Information
Typically, the employee may sit comfortably to perform the work; however, there may be some walking; standing; bending; carrying light items; driving an automobile, etc. Special physical demands are not required to perform the duties of this position.

Current Openings for Medicaid Billing Specialist Jobs at Demo Site