Revenue Cycle Specialist: Medicare Collections
Job Description
We are hiring Revenue Cycle Specialists who excel in Medicare Collections for our Revenue Operations Department. Specialists in this role will contact Medicare Administrative Contractors (MACs) to reconcile outstanding accounts receivable (debit balances), research and resolve problem accounts, and request adjustments or rebills on claims.
Duties :
- Research, initiate follow-up, and resolve all unpaid or underpaid system debit balances on Medicare insurance claims; includes but is not limited to remit review, calling payer(s) and clinics, rebilling, navigating payer portals, and taking adjustments.
- Uses critical thinking, problem-solving and analytical skills to determine the root cause of our underpayment and follow appropriate policy and procedure to remediate.
- Navigate through various payer systems and multiple internal systems to ensure timely and accurate resolution of Medicare claims.
- Uses exceptional organization, written, and verbal communication skills to produce detailed documentation of research and actions taken on claims Ad hoc monthly reporting of outstanding debit balances and trends.
- Stay current on communication relating to healthcare reimbursement and regulatory changes. Maintain confidentiality of all company and patient information in accordance with HIPAA regulations and Company policies. Qualifications :
- Min. 2 years of Medicare Experience years of experience with generic accounting, transactions, or medical billing systems required.
- Prior healthcare and medical billing / collections / denial remediation experience required.
- Intermediate computer proficiency in Microsoft Office tools including Excel, PowerPoint and Outlook. Education :
- Highschool Diploma or equivalent required.
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