Billing Operations Specialist - Medicare

Centene Corporation; Tampa (FL); Remote; Full time

Job summary

A leading company in healthcare is seeking a remote Billing Specialist to handle escalated Medicare member concerns. The role involves resolving billing disputes, preparing accurate billing, and ensuring compliance with policies. Candidates should have a strong background in billing and customer service, with a focus on Medicare. This position offers competitive pay and a comprehensive benefits package, emphasizing workplace flexibility.

Benefits

Health Insurance

401K

Stock Purchase Plans

Tuition Reimbursement

Paid Time Off

Flexible Work Schedules

Qualifications

• 3+ years of combined billing/collections, accounting or customer service experience.
• Ability to handle 40 caseloads at all times.

Responsibilities

• Handle escalated billing or healthcare complaints through outbound calls.
• Collaborate with internal teams to resolve disputes in billing.
• Prepare timely and accurate billing for external clients.

Skills

Billing

Customer Service

Accounting

Medicare

De-escalation

Education

High school diploma or equivalent

Bachelor’s degree in Business Administration

Job description

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

**Remote Role with training being held locally at the 8725 Henderson Rd, Tampa, FL** Candidates must reside within a reasonable distance to office location.

Position Purpose: This is a remote position handling escalated billing or healthcare complaints by making outbound calls to resolve these escalated Medicare member concerns. You will be researching unresolved issues that are related to multiple categories like, claims, enrollment, Pharmacy, Appeals, and Premium Billing.

• Collaborate with internal team and external client to research and resolve any disputes or discrepancies in billed amounts and/or payment transactions

• Prepare timely and accurate billing for external clients

• Document all collections efforts and transaction records

• Reconcile member accounts as needed

• Prepare bad debt write-off as needed

• Research and process refunds as needed

• Maintain low volume in assigned error queues within the billing system
• Performs other duties as assigned

• Complies with all policies and standards

Education/Experience: High school diploma or equivalent and 3+ years of combined billing/collections, accounting or customer service experience or Bachelor’s degree in Business Administration or related field.

Preferred Skills:

Strong Medicare or PDP (prescription Drug) Background

Experience de-escalating irate member calls

Ability to handle 40 caseload at all times (40 Different Members w/different concerns)

Work Force Management (WFM) background is beneficial

Work shifts: 9-5:30, 930-6pm or 10-630pm

Busy: October - Feb

Some Saturday work days – if work a Saturday you would get a weekday off.

Pay Range: $19.04 - $32.35 per hour

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act