Medicare Specialist (Part A & Part B billing experience required)

CorroHealth • IL-Remote, IL

8d • Remote

About The Position

Medical Reimbursement Specialists work with insurance carriers and patients to resolve outstanding balances through research, follow-ups, and appeals. This is a remote position, and the employee must live in the United States.

The role edits and maintains Medicare claims, follows up on billed claims, monitors patient accounts for accurate payment, and pursues reimbursement through compliant action. It also involves editing rejected claims in DDE identified on the RTP report, checking patient bills for accuracy and completeness, and obtaining missing information. The specialist is expected to maintain knowledge of current Medicare regulations and guidelines and adhere to those guidelines. Other duties may be assigned.

The position requires a high school diploma or GED and two years of experience resolving medical Medicare claims. Knowledge of Medicare and/or Medicaid payors is required. Familiarity with CPT and ICD-10 coding, insurance billing, medical terminology, and electronic and paper systems used in healthcare billing is preferred. The role also requires the ability to research unpaid or underpaid claims for resolution.

The work involves regular eye-hand coordination and manual dexterity to operate office equipment, working at a computer terminal for 6–8 hours per day, and functioning amid constant interruptions. The employee may sit for prolonged periods and, infrequently, must lift and move materials weighing up to 20 pounds. Elevated stress may occur during busy periods and when handling multiple deadlines. Reasonable accommodations may be made for individuals with disabilities to perform the essential functions.

Requirements

• High school diploma or GED equivalent.
• Two years of experience resolving medical Medicare claims.
• Knowledge of Medicare and/or Medicaid payors.
• Ability to research unpaid or underpaid claims for resolution.
• Must live in the United States.
• Regular eye-hand coordination and manual dexterity to operate office equipment.
• Ability to work at a computer terminal for 6–8 hours a day and function in an environment with constant interruptions.
• Ability to sit for prolonged periods.
• Infrequent ability to lift and move materials weighing up to 20 pounds.

Nice To Haves

• Familiarity with CPT and ICD-10 coding.
• Knowledge of insurance billing and medical terminology.
• Familiarity with electronic and paper systems used in billing healthcare services.

Responsibilities

• Edit and perform maintenance on Medicare claims.
• Follow up on billed claims in a timely and effective manner.
• Maintain knowledge of current Medicare regulations and guidelines.
• Monitor patient accounts for accurate payment.
• Pursue account reimbursement through compliant action.
• Edit rejected claims in DDE identified on the RTP report.
• Review patient bills for accuracy and completeness and obtain missing information.
• Utilize and adhere to Medicare guidelines.
• Perform other duties as assigned.

What This Job Offers

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