Billing Claims Analyst - Business Office

Springhill Medical Health Systems • Mobile, AL

1d • Onsite

About The Position

We are seeking an experienced Billing Claims Analyst with extensive knowledge of UB-04 billing and Medicare regulations. This role is responsible for accurate claim submission, follow-up, and resolution of Medicare hospital billing issues to ensure timely reimbursement and compliance with CMS guidelines.

Requirements

• High School Diploma or GED
• 5 - 10 years of hospital experience in 1500 and UB04 Billing, preferably Medicare
• Recent working knowledge in Medicare Direct Data Entry (DDE) System
• Proficiency navigating the WPS Medicare website, including ADRs, medical record uploads, appeals, and claim review
• In-depth knowledge of CMS Local Coverage Determinations (LCDs) related to hospital tests and procedures
• Experience calculating Medicare days (co-days, lifetime reserve days)
• Experience with Medicare edits, 72-hour overlap claims, clinical trials, and Hospice billing

Nice To Haves

• Coding certificate preferred

Responsibilities

• Accurate claim submission
• Follow-up on claims
• Resolution of Medicare hospital billing issues
• Ensure timely reimbursement
• Ensure compliance with CMS guidelines
• Analyze, resolve, and appeal claim rejections and denials from Medicare, other payers, and clearinghouse

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED