Medicare Coordinator I

Sarasota Memorial Health Care System; Sarasota (FL); On-site; USD 42,000 - 65,000; Full time

Job summary

Sarasota Memorial Health Care System is seeking a Medicare billing specialist to optimize account receivables and cash flow within the Patient Financial Services department. The role involves reviewing and processing electronic claims using AccessANYware, SSI, and DDE, solving denials, and educating staff on submissions.

Full-time, on-site at Support Services, with a 7am–9am flexible start window; requires at least four years in PFS and two specifically with Medicare billing, plus an Associate

Qualifications

• Minimum four (4) years in Patient Financial Services with two (2) years in Medicare billing and collections.
• Associate's degree or higher may be substituted for the Medicare billing and collections experience requirement.
• Preference for two (2) years of experience with Windows-based software applications and CPAT/CRCS certifications.

Responsibilities

• Perform Medicare billing and collection functions to maximize cash flow.
• Review and process electronic claims using AccessANYware, SSI and DDE.
• Educate and train staff in electronic claims submissions.
• Respond to incoming calls and walk-in patients.

Skills

Medicare billing

Accounts receivable

Claims processing

Education

Associate degree or higher

Tools

AccessANYware

SSI

DDE

Job description

Job Summary

Performs billing collection functions for Medicare account receivables keeping accounts to a minimum and cash flow to a maximum. Reviews and processes electronic claims along with analyzing and correcting claims via AccessANYware, SSI and DDE software systems to ensure timely reimbursement has been received. Problem solves RTP and denied claims and provides support/maintenance for the electronic Medicare billing system. Responsible for the coordination and updating of the CM and DDE billing updates, billing tables and system edits to ensure maximization of electronic capability. Responsible for running job streams, generating and evaluating electronic Medicare billing reports. Responsible for education and training of staff in electronic claims submissions. Keeps current on changes to Medicare billing regulations and compliance issues. Responds to incoming calls and walk-in patients.

Job Description

Department: Patient Financial Services

Performs billing collection functions for Medicare account receivables keeping accounts to a minimum and cash flow to a maximum. Reviews and processes electronic claims along with analyzing and correcting claims via AccessANYware, SSI and DDE software systems to ensure timely reimbursement has been received. Problem solves RTP and denied claims and provides support/maintenance for the electronic Medicare billing system. Responsible for the coordination and updating of the CM and DDE billing updates, billing tables and system edits to ensure maximization of electronic capability. Responsible for running job streams, generating and evaluating electronic Medicare billing reports. Responsible for education and training of staff in electronic claims submissions. Keeps current on changes to Medicare billing regulations and compliance issues. Responds to incoming calls and walk-in patients.

Required Qualifications

• Require a minimum of four (4) years of Patient Financial Services experience, two (2) of which are in working with Medicare billing and collections. An Associate's degree or higher can be considered in lieu of the Medicare billing and collections experience requirement.

Preferred Qualifications

• Prefer two (2) years of experience in utilizing Windows based software applications.
• Prefer Certified Patient Account Technician (CPAT), Certified Revenue Cycle Specialist (CRCS) or subsequent certification.
• Prefer the ability to analyze problems and consistently follow through to resolution.
• Prefer the ability to meet public and handle difficult situations diplomatically.
• Prefer working knowledge of ICD-10 and CPT coding.
• Prefer the ability to type a minimum of thirty (45) words per minute.

Mandatory Education

HS EQ: High School Diploma, GED or Certificate

Full time, M-F, 40 hours with flex start time from 7am to 9am; position is on site at Support Services location with no remote availability at current time

Employment Screening Requirements

As part of Sarasota Memorial Health Care System’s commitment to keeping people safe, all individuals providing care to vulnerable populations are required to undergo background screening through The Florida Care Provider Background Screening Clearinghouse. https://info.flclearinghouse.com/