Corp - Cincinnati1404 Race Street STE 302Cincinnati, OH 45202, USAThe Claims Management Specialist is responsible for managing the billing and claims lifecycle to ensure accurate claim submission, timely reimbursement, regulatory compliance, and effective collaboration with internal and external stakeholders. This role supports the organization's revenue cycle performance through proactive claims management, customer service, and adherence to Necco's corporate culture and operational standards.You should be accurately described as:A happy warrior who thrives on leading from the front with strategic thinking. A solid communicator in search of decisions that deliver real results. A problem-solver, financial steward, and one who excels at collaboration. Ridiculously passionate about the company's success, growth, and program quality.The candidate selected will be responsible for the following:Claims ManagementUtilize the Electronic Health Record (EHR) system to generate claims for per diem and fee‑for‑service billing and submit invoices to payorsReview and take action on submitted claims within 30–45 days to ensure timely resolutionMonitor, investigate, and resolve held, rejected, or denied claims using EHR and clearinghouse toolsAssist with cash application processes, including reconciliation of open accounts receivable balancesMaintain accurate documentation related to billing activities and claim outcomesCustomer ServiceFoster strong internal and external relationships to support timely resolution of billing discrepanciesCommunicate effectively with payors, service line teams, and leadership regarding claim status and issuesIdentify and recommend opportunities for process and policy improvement based on trends observed during collections and claim follow‑up.Collaborate with the Revenue Cycle Management Team to ensure systems, workflows, and processes operate efficientlyQuality Performance & Risk ManagementMaintain compliance with all regulatory agencies governing Medicaid and governmental billing practicesEnsure adherence to organizational policies, governmental regulations, and fiscal management standardsMaintain strict confidentiality of financial and client informationAssure compliance with HIPAA regulations related to billing and protected health informationDemonstrate ruthless pragmatism in problem solving and decision makingKnow and live the Necco Corporate Culture PrinciplesEmbody the three essential virtues of humble, hungry, and smartActively manage and drive Individual Performance Scorecard goalsParticipate in and contribute to Necco's meeting structure and organizational initiativesPosition QualificationsDegree or certificate in medical billing/coding (or nearing completion) preferred3+ years of experienceProficient with Microsoft Office SuitePreference for experience with claims submission to Medicaid/MCOs or governmental entitiesExperience with EHR and Clearinghouse SoftwareExperience managing complex, voluminous datasets and electronic recordsValid driver's license and 100/300/100 required auto insurance coverageStrong communication skills to build and maintain relationships with internal and external customers as well as provide valuable feedback to managementMust be self‑directed, resourceful, vigilant and persuasiveSuccessful completion of all required criminal background checksTravel/training willingnessAt Necco, we value diversity and are committed to creating an inclusive and equitable work environment. We embrace individuals of diverse backgrounds, experiences, and perspectives. We believe that a diverse team fosters innovation and creativity, and we actively seek candidates from all races, ethnicities, religions, genders, sexual orientations, abilities, and ages to join our organization. We are dedicated to providing equal opportunities for employment and advancement to all qualified individuals, and we encourage applicants of all backgrounds to apply.Equal Opportunity Employer. This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.#J-18808-Ljbffr