Inpatient Medicare Collection Specialist
TaraVista Behavioral Health•Devens, MA
•Onsite
About The Position
The Inpatient Medicare Collections Specialist is responsible for maximizing reimbursement and ensuring timely resolution of Medicare inpatient accounts receivable. This role focuses on Medicare fee-for-service claims, including high-dollar hospital stays, by managing claim edits, resolving denials, and navigating the Medicare Direct Data Entry (DDE/FISS) system to secure accurate and timely payment.
Requirements
- 1-3+ years of hospital billing or Medicare collections experience.
- Inpatient Psych experience preferred.
- Experience with Medicare DDE/FISS preferred.
- Knowledge of Medicare billing rules and IPPS
- Familiarity with Medicare Secondary Payer (MSP) rules
- Strong analytical and detail-oriented skills
- Proficiency in billing systems and Microsoft Office
Responsibilities
- Monitor Medicare DDE (FISS) system for claim status updates including edits, RTP, and suspended claims.
- Correct claim errors, billing discrepancies, and coding-related issues.
- Investigate and resolve denied, zero-pay, or underpaid Medicare claims.
- Prepare and submit redetermination and reconsideration appeals.
- Work Medicare aging reports daily and prioritize high-dollar accounts.
- Communicate with Medicare Administrative Contractors (MACs) to resolve claim issues.
- Coordinate patient responsibility and secondary billing.
- Ensure compliance with CMS regulations and proper documentation.
- Other Collections activity as assigned
Benefits
- Medical
- Dental
- Vision
- 401(k) match
- Employer paid short term disability (STD)
- Employer paid life and AD&D Insurance
- Generous Paid Time Off
- Flexible Spending Account
- Tuition Reimbursement
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
