[Hiring] Medicare Specialist @CorroHealth

Role Description

Medical Reimbursement Specialists work with insurance carriers and patients to resolve outstanding balances through research, follow-ups, and appeals.

Essential Duties and Responsibilities:

• Edit and perform maintenance on Medicare claims.
• Follow-up on billed claims in a timely and effective manner.
• Maintain knowledge of current Medicare regulations and guidelines.
• Monitor patient accounts for accurate payment.
• Pursue account reimbursement through compliant action.
• Edit rejected claims in DDE which are identified on RTP report.
• Review patient bills for accuracy and completeness and obtaining any missing information.
• Utilization and adherence to Medicare guidelines.
• Other duties as assigned.

Qualifications

• High School Diploma or GED equivalent.
• Two years (2) experience resolving medical Medicare claims.
• Knowledge of Medicare and/or Medicaid payors.
• Familiarity with CPT and ICD-10 coding preferred.
• Knowledge of insurance billing and medical terminology preferred.
• Familiarity with electronic and paper systems used in billing healthcare services.
• Ability to research unpaid or underpaid claims for resolution.

Requirements

• Regular eye-hand coordination and manual dexterity is required to operate office equipment.
• The ability to perform work at a computer terminal for 6-8 hours a day.
• Function in an environment with constant interruptions.
• Ability to sit for prolonged periods.
• Must be able to lift and move material weighing up to 20 lbs.
• May experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.