Medicaid Billing Specialist Job Description

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Medicaid billing specialists are medical billers who only handle Medicaid billing and claims. Job possibilities are high, and the medical billing field is estimated to increase by 20 percent till 2018, according to the U.S. Bureau of Labor Statistics. Medicaid billers play an important position in the back office staff. Correct claim submission and knowledge of the Medicaid systems are integral to clinics and hospitals receiving payment.

Duties

  • The major duties of Medicaid billers are submitting claims to Medicaid, examining denials and troubleshooting problems. Medicaid billers also maintain security procedures and confidentially to protect patients. Billers review patient files and assign codes to each service given. The claims are then examined for Medicaid guideline compliance and completion before submission. All claims are filed in a timely manner to get payment quickly. Billers also review daily billing reports and keep up with submission dates.

Skills

  • General medical billing experience is highly desired by employer. Employers ask for one to five years' experience depending on the position. A thorough knowledge of Medicaid billing procedure and laws is also required. Functional understanding of computers, the Microsoft Office suite and web browsing is also needed. Accuracy and speed of data entry is essential to succeeding. Additionally, billers should to know how to research any unknown codes. Other necessary skills include the ability to self-start and work alone or with team members.

Education

  • Associate degrees in Medical Billing or Coding are usually the springboard for Medicaid billers, but a high school degree with years of work experience is sometimes accepted. Programs last from nine months to two years. Higher degrees are also possible if advancement in the career field is sought. Coursework includes medical terminology, software management, medical coding procedure, anatomy, physiology and ICD guidelines, and documentation. Many programs are offered fully online or through night school.

Certification

  • Certification is an important process in Medicaid billing education. Certification from the American Health Information Management Association (AHIMA) or the American Academy of Professional Coders (AAPC) affords progress in a biller's career and earning potential. Many employers request that a biller is certified before sending in a résumé. Both associations have written tests that can last up to four hours. Though accredited schools prepare a student for the tests, each association offers its own preparation materials. AHIMA says, that certification can "increase your job mobility and choices even in the face of a tough job market."

Salary

  • Billing salary varies greatly depending on location, experience and work environment. The U.S. Bureau of Labor Statistics estimate the average income in the $30,000s, with those working in the physician offices getting mid $25,000s going up to $50,000 for federal workers. Consulting billers can make upward of $76,000, according to an AHIMA survey.

References

  • Photo Credit woman with computer in the office image by Oleg Berlov from Fotolia.com
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