Job Description

Join Our Team as a Medicaid Billing Specialist!

Behind every successful Medicaid claim is someone who cares about accuracy, problem-solving, and making a difference.

As a Medicaid Billing Specialist at Adelante, you'll play an important role in ensuring our programs receive the funding needed to provide life-changing services for people with disabilities, seniors, and other underserved members of our community.

Additional Areas of Responsibility:

• Prepare and submit Medicaid claims accurately and on time while following federal, state, and payer guidelines.
• Verify billing information, including client eligibility, authorizations, coding, and supporting documentation.
• Monitor and resolve denied or unpaid claims by researching issues, making corrections, and resubmitting claims when needed.
• Maintain compliance with New Mexico Medicaid regulations, HIPAA requirements, and billing policies.

Other Information/Requirements:

• High School Diploma or GED required.
• Associate degree in Accounting, Healthcare Administration, Business, or related field preferred.
• 1-3 years of Medical or Medicaid billing experience in healthcare, behavioral health, home and community-based services, or similar setting preferred.
• Experience billing New Mexico Medicaid and/or Medicaid managed care organizations strongly preferred.
• Working knowledge of medical reimbursement processes, claim forms, and insurance follow-up.

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