We are an established Adult Day Care Center seeking an experienced Medicaid Billing & Administrative Coordinator to join our team full-time. This is an on-site position. We are looking for someone with hands-on experience in Florida Medicaid billing who can take ownership of the billing process from authorization through payment while also assisting with general administrative duties. Primary Responsibilities

• Verify Medicaid eligibility and LTC authorizations.
• Track authorization effective dates, expiration dates, approved days and units.
• Review participant attendance and supporting documentation before billing.
• Reconcile authorization, attendance, service dates and units before submitting claims.
• Submit Medicaid and managed-care claims accurately and timely.
• Monitor claims from submission through final payment.
• Track paid, denied, rejected, adjusted, voided and outstanding claims.
• Research denials and correct/rebill claims when appropriate.
• Reconcile payments and remittance advice.
• Identify services that were attended but not billed.
• Identify claims that do not have sufficient supporting documentation and immediately report discrepancies to management.
• Maintain a monthly billing reconciliation for every participant.
• Monitor authorization expirations and notify management before services are affected.
• Communicate with MCOs regarding authorizations, claims and payment issues.
• Maintain organized documentation for Medicaid/MCO audits and record requests.
• Assist with scanning, patient files, correspondence and general office administration. Preferred Experience
• Florida Medicaid billing experience required.
• Florida Medicaid Long-Term Care (LTC) experience strongly preferred.
• Adult Day Care, Home Health, ALF, HCBS or similar Medicaid-provider experience strongly preferred.
• Experience with Medicaid managed-care organizations such as UnitedHealthcare, Molina, Humana, Florida Community Care and Simply/Florida Blue preferred.
• Experience with Availity and individual insurance portals.
• Experience reviewing authorizations, claims, denials, remittance advice and eligibility.
• Knowledge of Medicaid documentation and audit requirements.
• Strong Excel and computer skills.
• Extremely organized and detail-oriented.
• Bilingual English/Spanish preferred.

Critical Billing Control Before submitting any claim, the Billing Coordinator must verify that the authorization, participant attendance, date of service and authorized units support the claim. Historical or participant documentation may never be altered simply to make documentation correspond with billing. Monthly Reporting The Billing Coordinator will provide management with a monthly reconciliation showing: Participant | Authorized Days/Units | Attendance | Billed | Paid | Denied | Outstanding | Unbilled Attendance | Action Required We are looking for someone who doesn't simply "send claims." We want an experienced professional who follows claims through payment, catches discrepancies, resolves denials and keeps management informed. This position is 100% on-site.

Pay:

$22.00 - $28.00 per hour Expected hours: No less than 30.0 per week

Benefits:

Paid time off

Experience:

Medical billing: 2 years (Required)

Language:

English (Required)

Work Location:

In person