Medicare and Medicaid Billing Specialist/ LifeBridge Health

City of Baltimore, Mayor's Office of Employment Development • Westminister, MD

2d • Onsite

About The Position

LifeBridge Health is seeking a Medicare and Medicaid Billing Specialist to join their team. This role is responsible for ensuring timely and accurate claim submissions, managing denials, resolving payment variances, and managing accounts receivable. The specialist will work with hospital claims daily, documenting all activities within the hospital systems. They will also investigate and report systemic billing issues, identify administrative denials, and manage appeals and corrective actions to secure claim payments. Additionally, the role involves utilizing payor acceptance and 277 reports to address rejections and applying appropriate holds for claims based on billing requirements, coding needs, and data deficiencies.

Requirements

• Experience with Medicare and Medicaid billing.
• Proficiency in claim submission, denial management, and accounts receivable resolution.
• Experience with hospital billing systems.
• Ability to investigate and resolve systemic billing issues.
• Experience with appeal processes and corrective actions for claim payment.
• Familiarity with payor acceptance reports and 277 reports.
• Understanding of billing requirements, coding needs, and data deficiency.

Responsibilities

• Completes timely claim submission, denial management, payment variance, and accounts receivable resolution.
• Imports, edits, corrects and transmits hospital claims on a daily basis.
• Ensures activity is fully documented related to claim submission, follow-up and resolution in hospital systems.
• Investigates and/or refers to management systemic billing issues that cause delays in reimbursement.
• Identifies administrative denials by working denial work-items and through remittances; follows through with appeal or corrective action to obtain claim payment.
• Applies payor acceptance reports and 277 reports to manage payor rejections and take appropriate action for resolution.
• Applies appropriate HOLDS and subsequently releases claims based on billing requirements, coding needs and data deficiency.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 5,001-10,000 employees