Medicare Specialist
About The Position
Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success. Medicare Specialists work with Medicare and/or Medicaid, and patients to resolve outstanding balances through research, follow ups and appeals. Epic experience required as well as Hospital Billing HB experience.
Requirements
- 4+ years of experience resolving medical Medicare claims
- Expert Epic experience required
- High School Diploma or GED equivalent
- Knowledge of Medicare and/or Medicaid payors
- Familiarity with electronic and paper systems used in billing healthcare services
- Ability to research unpaid or underpaid claims for resolution
Nice To Haves
- Familiarity with CPT and ICD-10 coding preferred
- Knowledge of insurance billing and medical terminology preferred
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 which are identified on RTP report.
- Review patient bills for accuracy and completeness and obtaining any missing information.
- Utilization and adherence to Medicare guidelines.
- Other duties as assigned.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
