Medicare Billing & Follow-Up Specialist (CRCS)

Chesapeake Regional Healthcare; Chesapeake (VA); Vor Ort; USD 42.000 - 65.000; Vollzeit

Zusammenfassung

Chesapeake Regional Healthcare in Virginia seeks a Medicare Billing and Follow-up Representative to ensure compliant, accurate and timely billing for all Medicare and Medicare Advantage patient accounts.

Responsibilities include submitting electronic and paper claims, resolving billing edits, and following up on unpaid claims to maximize reimbursements. Proficiency in ICD-10, CPT-4, HCPCS and CMS guidelines is essential, with familiarity of Palmetto GBA and CMS updates a plus.

Qualifikationen

• 3+ years in hospital billing with Medicare knowledge.
• CRCS certification preferred or equivalent experience.
• Strong understanding of payer rules and compliance requirements.

Aufgaben

• Submit Medicare/Medicare Advantage claims electronically and on paper (UB-04 and 1500).
• Resolve billing edits and MAC/MAC-based warnings and denials.
• Follow up on unpaid claims until resolution is achieved.
• Work with MSP, TPL, and CMS guidelines and documentation.
• Interpret LCD/NCD policies and CMS updates to ensure medical necessity.
• Prepare and send letters to payers and patients as needed.

Kenntnisse

Medicare billing

Hospital billing

Billing follow-up

Accounts receivable

Compliance

Ausbildung

CRCS certification

College degree preferred

Tools

MPF

Epic HB

OnBase

DataArk

MedAssets

Jobbeschreibung

Chesapeake Regional Healthcare in Virginia seeks a Medicare Billing and Follow-up Representative to ensure compliant, accurate and timely billing for all Medicare and Medicare Advantage patient accounts.

Responsibilities include submitting electronic and paper claims, resolving billing edits, and following up on unpaid claims to maximize reimbursements. Proficiency in ICD-10, CPT-4, HCPCS and CMS guidelines is essential, with familiarity of Palmetto GBA and CMS updates a plus.