Job Application - Cortland County Community Action Program

Job Posting CLOSED

Medicaid Billing Specialist

Position: Medicaid Billing Specialist

Department: Administration

Reports to: Fiscal Director

Status: Full-time, Non-Exempt

Schedule: Monday through Friday 8am-4pm; 37.5 hours per week

Wage Range: $18.00 – $20.00


Job Function: Responsible for the review, preparation, and follow-up of billing claims for CAPCO’s Consumer-Directed Services Program (CDPAP), including Medicaid managed care billing for CDPAP.

Primary Duties and Responsibilities
include the following. Other duties may be assigned.

  • Prepares, reviews, and enters electronic and manual billing claims to Medicaid managed care carriers and other third-party payers timely and accurately and in accordance with all rules and regulations.
  • Conducts thorough audit review of billing claims prepared by Consumer-Directed Services (CDS) department, working to resolve issues with claims before submission.
  • Ensures all billing documentation is complete and accurate for claim submission.
  • Monitors and follows-up on all claim remittance statuses to ensure timely and full payment of claims.
  • Initiates review of claim remittance reports to identify payment denials for review and resubmission.
  • Works closely with CDS department staff to resolve issues associated with claim denials and to correct errors for claim re-billings.
  • Works with CDS department to perform appropriate analysis, research, and other collection activities to follow-up on non-adjudicated claims, including contacting Medicaid carrier representatives and other payers as necessary.
  • Prepares claim re-billing submissions with all proper documentation.
  • Serves as central point for maintaining submitted billing files.  
  • Works with supervisor and CDS department to identify and resolve trends when claims are denied and implements approved process changes as needed.
  • Functions as a resource to fellow colleagues when questions or issues arise and works closely with the CDS department to identify process flows and resolve issues accurately and promptly.
  • Work efficiently and accurately within billing software platforms, continuously developing knowledge of systems to review output and identify necessary changes for accurate claim submissions.
  • Maintains working knowledge of Medicaid billing regulations and third-party insurance/payer requirements, participating in relevant professional development trainings.
  • Performs other Fiscal department tasks and projects assigned by the supervisor.


Qualifications and Requirements:  High School Diploma or equivalency required; Associate degree in related field preferred; plus 1-3 years’ experience; or equivalent combination of education and experience.


CAPCO is an Equal Opportunity Employer and we do not discriminate against employees or applicants for employment on any legally recognized basis including, but not limited to: veteran status, uniform service member status, race, color, religion, sex, sexual orientation, age, and physical or mental disability. CAPCO will make reasonable accommodations for qualified candidates in adherence of the Americans with Disabilities Act and New York Human Rights Act.