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Medicare Billing Specialist
2 months ago
As a Medicare Billing Specialist at Arkansas Surgical Hospital, you will be responsible for overseeing and executing Medicare billing processes, ensuring the precise and prompt submission of claims. Familiarity with SSI billing is advantageous, though not mandatory. The ideal candidate will possess a comprehensive understanding of Medicare billing regulations and be adept at navigating intricate reimbursement procedures to facilitate timely payments.
Core Responsibilities:
- Medicare Claims Processing: Prepare, examine, and submit Medicare claims for services rendered, in compliance with Medicare standards and regulations.
- Claims Oversight: Track the progress of Medicare claims, address billing discrepancies, and resubmit claims as necessary to ensure prompt reimbursement.
- Coding and Record Review: Analyze medical documentation to assign correct codes and descriptions for Medicare billing, ensuring adherence to CMS (Centers for Medicare & Medicaid Services) standards.
- Follow-up Procedures: Engage with Medicare and SSI payers to monitor claim status, resolve denials, and secure payments.
- Payment Reconciliation: Conduct payment reconciliations, verify EOBs (Explanation of Benefits), and manage adjustments as required.
- Documentation Accuracy: Ensure all billing records are thorough and precise, maintaining organized documentation for audit readiness.
- Collaboration and Training: Work alongside healthcare providers and administrative personnel to educate them on Medicare billing practices and address their billing-related questions.
A High School diploma or G.E.D is preferred.
Experience and Qualifications:
- Prior experience in Medicare billing is essential; knowledge of SSI billing is a bonus.
- Familiarity with Medicare regulations and guidelines is crucial.
- Strong knowledge of CPT, ICD-10, and HCPCS coding systems.
- Proficiency in medical billing software and electronic health record (EHR) systems.
- Exceptional attention to detail and accuracy in billing and coding.
- Strong analytical and communication skills.
- Understanding of healthcare revenue cycle management.
- Experience with SSI billing is advantageous but not required.
This role necessitates the ability to lift, carry, push, and/or pull up to ten pounds. It involves stooping, kneeling, crouching, reaching, grasping, handling, and balancing for five or more hours daily. Sensory and communicative activities, including hearing, seeing, and speaking, are essential to perform the fundamental job functions.
Work Environment Considerations:
Potential exposure to environmental hazards such as chemicals, solvents, needles, sharps, blood, body fluids, various infectious diseases, and medical waste. Use of protective clothing and equipment may be necessary.
THIS JOB DESCRIPTION IS NOT INTENDED TO BE AN EMPLOYMENT CONTRACT, NOR DOES IT ALTER THE 'AT WILL' EMPLOYMENT RELATIONSHIP.
