<p>Advertisement Closes</p> <p>5/26/2025 (8:00 PM EDT)</p> <p>25-03104</p> <p>Medicaid/Medicare Srvs Specialist III</p> <p>Pay Grade 15</p> <p>Salary</p> <p>$46,146.72 - $69,221.28 Annually</p> <p>Employment Type</p> <p>EXECUTIVE BRANCH | FULL TIME | ELIGIBLE FOR OVERTIME PAY | 18A | 37.5 HR/WK</p> <p>Click here for more details on state employment.</p> <p>Hiring Agency</p> <p>Cabinet for Health & Family Services | Dept for Behav Health, Dev & Int Disab</p> <p>Location</p> <p>275 East Main Street</p> <p>Frankfort, KY 40621 USA</p> <p>The agency may authorize the selected candidate to telecommute. The agency may terminate or modify the telecommuting arrangement at any time</p> <p>Description</p> <p>Do you have experience with an electronic medical record system, insurance billing, and reimbursement? If so, our Medicaid/Medicare Services Specialist III position may be the perfect role for you! We are looking for a Medicaid/Medicare Services Specialist III to join our team in the Division of Administration and Financial Management within the Department for Behavioral Health, Developmental and Intellectual Disabilities.</p> <p>Our work environment values diversity and inclusion and we offer benefits including health, life insurance, flexible work schedules, paid sick and vacation leave and retirement benefits.</p> <p>Responsibilities include but are not limited to:</p> <ul> <li>Provides assistance to facilities(providers) and DBHDID in program policy, Medicaid/Medicare cost reporting, claims, billing, and reimbursement for all BHDID facilities including four psychiatric hospitals, two long- term care nursing facilities for citizens with Serious Mental Illness (SMI), and four intermediate care facilities as it relates to revenue maximization. </li><li>Performs troubleshooting and problem resolution in electronic medical record system for facility Medicaid/Medicare billing and reimbursement issues that impact revenue. Identifies billing and reimbursement issues and works with facilities for resolution. Reviews Aged Trial Balance report. Assists facilities with identifying and updating issues affecting accounts receivable. </li><li>Provides support in examining and analyzing data, records, Medicaid/Medicare and MCO claims and billing and required documentation pertaining to DBHDID facility Medicare/Medicaid cost reports in accordance with state and federal guidelines. </li><li>Advises management concerning impact of federal or regulatory changes, state and federal. Prepares routine, technical and ad hoc reports to support and identify billing and revenue issues to aid in revenue maximization. </li><li>Receives and analyzes information related to insurance and managed care organizations including Medicaid, Medicare, and MCO. Analyzes information and prepares reports for respective facilities and management. Collaborates with facilities and insurance and managed care organizations to negotiate terms of agreements. Assists in managing and monitoring errors and trends and recommends system modifications as needed. </li><li>Performs other duties as assigned. </li></ul> <p>The ideal candidate would have:</p> <ul> <li>Experience with electronic medical records, Meditech preferred. </li><li>Experience in data collection and structured query language (SQL) </li><li>Advanced Excel functions </li><li>Knowledge of medical coding such as Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), and International Classification of Diseases, 10th Edition (ICD-10) codes. Knowledge of Medicaid/Medicare billing and reimbursement for psychiatric hospitals, nursing facilities and/or intermediate care facilities for individuals with intellectual disability. </li><li>Good analytical skills and attention to details. </li><li>Strong organizational skills and ability to coordinate the efforts of others. </li><li>Customer service focused. </li><li>Good time management skills and self-motivation. </li><li>Strong problem-solving skills. </li></ul> <p>The Cabinet for Health and Family Services (CHFS) participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in U.S. CHFS will only use E-Verify once you have accepted a job offer and completed the Form I-9.</p> <p>For more information on E-Verify, or if you believe that CHFS has violated its E-Verify responsibilities, please contact Department of Homeland Security (DHS) at 888-897-7781 or https://www.e-verify.gov/.</p> <p>Minimum Requirements</p> <p>EDUCATION: Graduate of a college or university with a bachelor's degree.</p> <p>EXPERIENCE, TRAINING, OR SKILLS: Four years of experience in Medicaid or Medicare program administration, health insurance administration/systems, eligibility systems, health care research, health care planning, health care financial management, health care policy development, human service or health care administration, insurance billing and/or claims, or research, review, and analysis of legislation or regulations.</p> <p>Substitute EDUCATION for EXPERIENCE: NONE</p> <p>Substitute EXPERIENCE for EDUCATION: Experience in the above areas will substitute for the required college on a year-for-year basis. Current or prior military experience will substitute for the required college on a year-for year basis.</p> <p>SPECIAL REQUIREMENTS (AGE, LICENSURE, REGULATION, ETC.): NONE</p> <p>Working Conditions</p> <p>Incumbents working in this job title primarily perform duties in an office setting.</p> <p>Probationary Period</p> <p>This job has an initial and promotional probationary period of 6 months, except as provided in KRS 18A.111.</p> <p>If you have questions about this advertisement, please contact Jennifer Moore at jennferc.moore@ky.gov or 502-782-6117.</p> <p>An Equal Opportunity Employer M/F/D</p>