MEDICARE BILLING SPECIALIST Business & Information Technology Hours: Mon -Fri 8am - 4:30pm Day Shift - Full Time Paygrade/Wages/Salary Info: NE N21 - 18.7000 - 23.5000
Medicare Billing Specialist Position Highlights: # The Medicare Billing Specialist reviews claims for completeness, reasonableness of charges and appropriateness of billing codes and Medicare information. The MBS work edits, bill holds, verifies Medicare/Insurance prior to submitting electronically, or hard copy claims if appropriate. The MBS works Medicare claims On-line DDE, (RTP) return to provider and (ADR) additional development request and assures all billing requirements are met for Research claims. # # The Ideal Candidate: # #Exhibits a problem-solving attitude; constantly seeks ways to improve processes, increase efficiency, and find solutions to current situations or to develop new methods and procedures. #Ability to multi-task and prioritize work in a deadline driven environment #Works effectively and constructively to find mutually beneficial solutions for all concerned parties. #Must be able to work collaboratively in a multi-team environment. #Accepts accountability for actions, choices, and outcomes; assumes nothing; answers for own conduct and obligations. #Is dedicated to superior customer service and satisfaction. # Responsibilities # #Work Medicare claims by clearing CCI/Internal edits and working bill holds within ePremis billing system. #Review, electronic EOB (835) for the primary payer, make corrections to and ensures the legibility of outgoing MSP claims. #Daily billing of Medicare/MSP Claims #Verifies Medicare and Insurance information and checks each claim for correctness on daily basis. #Bills Hard copy claims that are not eligible for electronically remittance. #Shares responsibility transmitting claims. #Make all Medicare corrections on-line DDE. #Analyze rejection codes and volumes. Report findings to Manager, Supervisor or Lead. #Assist with rectifying ongoing rejection reasons #Request Medical records on requested ADR#s. #Submit insurance informational, no-pay claims and ancillary claims. #Makes adjustments when necessary to all Medicare claims. #Rebilling#claims as needed, resubmitting unpaid claim that have rejected or have not paid. #Respond to questions and inquiries from other departments concerning the account that have not been paid by Medicare. # Credentials and Qualifications: # #Associate#s Degree #Minimum of four (4) years# experience working in a hospital, physician, or other medical services facility. #Minimum of three (3) years# experience in healthcare billing in Medicare Part A/B and Medicare secondary payers. o###In lieu of Associate#s degree, a H.S. Diploma with two (2) years# (for 5 years total) of additional related healthcare billing, patient financial services and/or revenue cycle experience may be considered.# #Solid understanding of Medicare billing rules and regulations. #Knowledge of third-party payers according to guidelines set forth in the department policy and procedure manual.