Medicare Appeals Specialist

Job Summary

Working remotely on a full-time basis, the Medicare Appeals Specialist will manage billing and follow-up activities related to Medicare, ensuring compliance with regulations and processing denials effectively.

Key responsibilities

• Prepare and submit billings promptly while responding to inquiries from Medicare
• Conduct follow-up activities for appeals and fair hearings, handling all related correspondence
• Review and advise on changes in Medicare regulations, ensuring adherence to guidelines and passing quality assurance audits

Required qualifications

• Minimum of one (1) year of medical billing experience, with a preference for ambulance coding and appeals
• Prior experience in Medicare billing and knowledge of Medicare terminology is highly preferred
• High school diploma or GED required; college courses in relevant fields are preferred
• Proficiency in Microsoft Office Suite and experience with patient accounting systems
• Working knowledge of medical terminology and ICD-9 and 10 coding