Medicaid Claims Analyst

GOBHI

Medicaid Claims Analyst processing claims for GOBHI’s Non-Emergent Medical Transportation (NEMT) program. Reviewing, auditing, and reconciling claims while ensuring compliance with regulations.

Posted 5/19/2026full-timeRemote • Oregon • 🇺🇸 United StatesJuniorMid-Level💰 $28 per hourWebsite

About the role

Key responsibilities & impact

Review, validate, and process NEMT claims in accordance with Medicaid policies, GOBHI program guidelines, and contractual requirements.
Perform accurate billing and coding for NEMT claims using appropriate HCPCS/CPT codes.
Verify member eligibility, trip authorization, and service documentation prior to submission.
Ensure claims are submitted within required timelines and track adjudication through final payment.
Identify and resolve claim errors, discrepancies, and denials in coordination with providers and program staff.
Maintain current knowledge of Medicaid billing codes, guidelines, and NEMT-specific requirements.
Conduct regular audits of NEMT claims to detect and prevent errors, overpayments, or potential fraud.
Support corrective action plans and recommend process improvements to strengthen billing integrity.
Accurately code trips and services in compliance with Medicaid and NEMT guidelines.
Prepare, review and submit billing batches to Medicaid and other payers.
Reconcile claims against payments, identifying variances or unpaid balances.
Collaborate with GOBHI finance staff to support accurate accounting and reporting.
Generate and maintain reports on claims activity, denial rates, and reimbursement trends.
Provide data analysis to identify cost drivers, claim patterns, and areas for improvement.
Serve as a resource for NEMT providers regarding Medicaid billing procedures, documentation, and claim resolution.
Upon supervisor’s approval and direction, update and maintain provider rate contracts.
Provide training and technical assistance to providers on coding, billing, and submission processes.
Other duties as assigned.

Requirements

What you’ll need

Two years’ experience in Medicaid claims processing, billing, or healthcare reimbursement
Experience working in transportation claims strongly preferred
Knowledge of Medicaid billing, HCPCS/CPT coding, and claims submission requirements
Strong analytical skills and attention to detail
Excellent problem-solving, communication, and organizational abilities
Handles highly sensitive and confidential information and complies with HIPAA requirements
Technology savvy, proficient using MS software and Google Suites
Experience with claims management systems, billing software, and Microsoft Excel
Capacity to handle multiple priorities and meet strict deadlines
Education – Associate’s degree in Business, Accounting, Healthcare Administration, or a related field. Bachelor’s degree preferred.

Benefits

Comp & perks

Medical, dental and vision insurance for you and dependents
22 paid time off days and 12 paid holidays
EAP
FSA, with a $500 employer contribution
Triple AAA insurance
Mileage reimbursement
Wellness benefits
401k contribution, including 6.5% employer contributions
Cell phone and internet reimbursements

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

Medicaid claims processingbillingHCPCS codingCPT codingclaims submissiondata analysisauditingcoding accuracyreconciliationprocess improvement

Soft Skills

analytical skillsattention to detailproblem-solvingcommunicationorganizational abilitiesconfidentialitytime managementtrainingtechnical assistancecollaboration