Medicare Coverage & Billing Analyst I

Baylor Scott & White Health; Highland Park (TX); On-site; USD 55,000 - 85,000; Full time

Benefits offered by this job

Health benefits

401(k) match up to 5%

Tuition reimbursement

PTO Day 1

Job summary

Baylor Scott & White Health is seeking a Research Billing Compliance Specialist to ensure Medicare coverage review and billing grids are compliant and accurate. The role requires building billing grids, interpreting research protocols and guidelines, and coordinating with revenue cycle teams to prevent errors and penalties while maintaining regulatory alignment.

Ideal candidates will have at least two years of related experience and the ability to read complex clinical and legal text, with

Qualifications

• Bachelor's degree required.
• Minimum two years of experience in research billing compliance.
• Experience with research budgeting/contracting and medical billing.

Responsibilities

• Conducts comprehensive examination of Medicare coverage policies and guidelines.
• Builds billing compliant coverage examination billing grids.
• Reviews and interprets research protocols, practice and billing guidelines to establish Medicare coverage eligibility.
• Collaborates with healthcare providers and billing departments to ensure accurate and compliant billing practices.
• Stays up to date with changes in Medicare regulations and communicates updates to relevant departments.
• Prepares detailed reports and documentation to support coverage determinations and appeals.

Skills

Billing compliance

Medicare policies

Education

Bachelor's

Job description

Baylor Scott & White Health is seeking a Research Billing Compliance Specialist to ensure Medicare coverage review and billing grids are compliant and accurate. The role requires building billing grids, interpreting research protocols and guidelines, and coordinating with revenue cycle teams to prevent errors and penalties while maintaining regulatory alignment.

Ideal candidates will have at least two years of related experience and the ability to read complex clinical and legal text, with