Job Description

Insight Global is looking for a Medicaid Specialist to support a large hospital system in Annapolis, MD. A Medicaid Specialist is a healthcare professional who specializes in the administration of Medicaid programs. They play a crucial role in ensuring that individuals and families enrolled in government-funded health insurance plans have access to the care they need. Medicaid specialists may also be known as case managers or social workers.

 Eligibility Determination:

o Review applications for Medicaid eligibility and submit recommendations to state agencies regarding approval or denial of benefits.

o Ensure accurate and timely processing of eligibility paperwork.

 Claims Processing:

o File claims with insurance companies on behalf of patients who have private health insurance. This helps ensure coverage for approved treatments and procedures.

o Review medical records to verify that all necessary procedures have been followed and documented correctly.

 Patient Interaction:

o Interview patients to obtain information about their physical and mental health history.

o Establish relationships with patients and their families, helping them understand their treatment plan and follow through on treatment recommendations.

 Coordination of Care:

o Collaborate with primary care physicians, specialists, hospitals, pharmacies, and other healthcare providers to ensure seamless patient care.

o Monitor patients' progress and promptly alert physicians to any issues requiring additional attention

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to HR@insightglobal.com .

To learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/ .

Skills and Requirements

High School Diploma or higher

 2 years of experience within insurance (Medicaid or Medicare)

 Knowledge of CMS guidelines in terms of billing

 Knowledge of Maryland reimbursement guidelines

 Technologically savvy (Microsoft suite experience)

 Experience with ERP and EMR systems null

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal employment opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment without regard to race, color, ethnicity, religion,sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military oruniformed service member status, or any other status or characteristic protected by applicable laws, regulations, andordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or the recruiting process, please send a request to HR@insightglobal.com.