Medicare Billing Specialist

Medicare Billing SpecialistClick Here to Apply OnlineJob DescriptionLocation: St. Joseph Medical CenterPosted Date: 9/23/2024Job Type: Full TimeDepartment: 4119.71800 CommunicationsUnder the direction of the Director of Revenue Cycle or designee, the Medicare Billing Specialist ensures all traditional Medicare and Medicare Managed Care claims are reviewed for claim edits, claim submission, and timely follow up, as assigned. Duties and Responsibilities:Review claims before submission for missing modifiers, charges, and/or implantsValidate and make corrections on the UB04 resolving all claim edits before claim submissionEnsure Medicare Managed Care no pay shadow claims are submitted to traditional MedicareWork suspended claims in the Medicare DDE system, as neededValidate pharmacy quantities are reflected on the claim correctlyValidate claim against the coding abstract to ensure accurate billing of proceduresReview 24 and 72-hour admission report combining claims, as neededSplit inpatient claims as appropriate, per carrier guidelinesSubmit claims to carriers with the appropriate remarks and/or attachmentsRun insurance eligibility and correct claim before submission, as neededPull supporting documents for annual regulatory audits, as neededEnsure Medicare credit balances are reviewed and resolved timelyEnsure CMS Medicare Credit Balance Certifications are filed quarterlyOther billing assignments, within skillsets and abilities EducationHigh School graduate or equivalentExperienceMinimum 2-years Medicare billing experience in an acute care facility Working knowledge of Common Procedural Terminology (CPT) and ICD10 CodesWorking knowledge of Federal, State, and Commercial billing guidelines Application InstructionsPlease click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you