Medical Billing Revenue Cycle Appeal Determination Medicare

Medical Billing – Revenue Cycle – Appeal Determination - Medicare

Location: Remote or On-Site

Hourly Pay: $18

Work Schedule: Full-Time, 40 hrs/wk, Mo–Fr, 7 am–7 pm

JOB SUMMARY

The Medical Billing – Revenue Cycle - Appeal Determination – Medicare position is responsible for reviewing incorrectly processed and/or denied claims to determine next appropriate actions to resolve the claim.

ESSENTIAL FUNCTIONS/DUTIES

• Process remittance advice notices from Medicare claims (primary, secondary, tertiary) to determine next actions.
• Obtain and document reprocessing and/or appeal related data to resolve the incorrectly processed/denied claim.
• Assure process and resources are allocated to provide required payor documentation assembly and filing.
• Analyze work processes to maximize efficiency.

QUALIFICATIONS

Required Experience:

• Must be fluent in English
• Minimum three (3) years experience in a healthcare revenue cycle billing environment (medical billing)
• Above average knowledge of Medicare and/or Medicare Replacement billing guidelines
• Ability to read and decipher an explanation of benefits and/or remittance advice notices
• Minimum of one (1) year working in a call center environment
• Ability to work independently or as an active member of a team
• Must possess empathic and professional written and verbal communication skills
• Knowledge and experience of computers and related technology, at an intermediate level

Preferred Experience:

• A minimum of one (1) year working in a customer service

Preferred Education:

• High school diploma
• GED
• Or significant, relevant work experience

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