Medicare Advantage Billing & AR Specialist

Medical Billing Specialist; Lima (OH); On-site; USD 38,000 - 52,000; Full time

Job summary

Health Partners of Western Ohio in Lima, OH is seeking an Accounts Receivable Specialist to support the revenue cycle by processing, submitting, and following up on insurance claims for Medicare Advantage payers in accordance with FQHC requirements.

The role focuses on reviewing coverage and demographics for billing accuracy, reconciling remittances, and actively managing accounts receivable aging with timely follow-ups to maximize collections.

Qualifications

• Knowledge of FQHC billing requirements.
• Prepare, submit, and follow up on insurance claims to Medicare Advantage payers.
• Monitor accounts receivable aging and actively follow up on unpaid or underpaid claims.

Responsibilities

• Review insurance coverage and patient demographic information to ensure accuracy before billing.
• Prepare, review, submit, and track insurance claims to Medicare Advantage payers in accordance with FQHC, state, and federal requirements.
• Process reimbursements and reconcile remittance reports with payments.
• Monitor AR aging and follow up on unpaid or underpaid Medicare Advantage claims.

Skills

Accounts receivable

Insurance claims processing

Medicare Advantage billing

Data accuracy

Billing compliance

Job description

Health Partners of Western Ohio in Lima, OH is seeking an Accounts Receivable Specialist to support the revenue cycle by processing, submitting, and following up on insurance claims for Medicare Advantage payers in accordance with FQHC requirements.

The role focuses on reviewing coverage and demographics for billing accuracy, reconciling remittances, and actively managing accounts receivable aging with timely follow-ups to maximize collections.