Medicare Billing Specialist

Job Summary

Managing the billing and collection processes for Medicare patients, the full-time Medicare Billing Specialist will ensure compliance with Medicare policies, process claims, and resolve billing issues while working remotely.

Key responsibilities:

• Prepare and submit accurate Medicare claims, utilizing tools to track and follow up on unpaid or denied claims
• Review patient accounts, reconcile payments, and communicate with patients regarding their Medicare coverage and billing inquiries
• Investigate and resolve denied or underpaid claims, preparing appeals and collaborating with internal departments as needed

Required qualifications:

• 3-5 years of hospital Business Office billing and follow-up experience as a Medicare representative
• Experience utilizing Payer portals, DDE, and client systems
• Knowledge of medical terminology, ICD-10, CPT, and DRG
• High school diploma or equivalent
• Familiarity with third-party insurance payer guidelines