Medicare Claims Specialist

Job Summary

Working remotely in a full-time capacity, the Medicare Claims Specialist will edit and maintain Medicare claims, follow up on billed claims, and ensure compliance with current regulations while pursuing account reimbursements.

Key responsibilities

• Edit and perform maintenance on Medicare claims and monitor patient accounts for accurate payment
• Follow up on billed claims in a timely manner and edit rejected claims identified on the RTP report
• Maintain knowledge of current Medicare regulations and guidelines, ensuring adherence in all actions taken

Required qualifications

• High School Diploma or GED equivalent
• Two years of experience resolving medical Medicare claims
• Knowledge of Medicare and/or Medicaid payors
• Familiarity with CPT and ICD-10 coding preferred
• Ability to research unpaid or underpaid claims for resolution