Medicare Specialist

HCA Healthcare, Inc.; Hendersonville (TN); Remote; USD 48,000 - 62,000; Full time

Benefits offered by this job

Comprehensive benefits

401(k) match on 3–9%

Education support

Wellbeing support

Paid time off and family leave

Adoption assistance

Life insurance

Job summary

Parallon, a part of HCA Healthcare, seeks a Medicare Specialist to handle all aspects of Medicare receivable processing, including billing, collection, account maintenance, and productivity reporting. You will review claims for completeness and payer information, follow up to ensure timely collections, and keep systems updated with current account data.

You will maintain knowledge of regulations, support teammates, and strive to submit clean Medicare claims while meeting daily productivity

Qualifications

• 1 year in a productivity/quality-based role or direct office experience preferred.

Responsibilities

• Maintains current knowledge of office operations, job specific requirements and related regulations
• Reviews all claims for completeness, reasonableness of charges, and appropriateness of billing codes, and payer information
• Pursues timely collection of each claim using thorough follow-up efforts appropriate to each payer
• Contacts and effectively communicates with all parties involved in the resolution of accounts placed
• Completes work request timely and in accordance with instruction
• Performs all tasks necessary to maintain current and accurate account information in each of the appropriate systems
• Maintains department daily productivity goals in completing a set number of accounts while also meeting quality standards as determined by leadership
• Provides support for team members that may be absent or backlogged
• Analyzes, investigates, and resolves outstanding edits in order to submit clean claims to Medicare
• Performs appropriate non-billable adjustments and plines as necessary
• Brings problems and troubling accounts, as well as related questions, to his/her immediate supervisor’s attention daily

Skills

1 year in productivity/quality-based

Job description

This Work from Home position requires that you live and will perform the duties of the position; within 60 miles of an HCA Healthcare Hospital (Our hospitals are located in the following states: FL, GA, ID, KS, KY, MO, NV, NH, NC, SC, TN, TX, UT, VA).

Do you want to join an organization that invests in you as a Medicare Specialist? At Parallon, you come first. HCA Healthcare has committed up to 300 million in programs to support our incredible team members over the course of three years.

Job Summary and Qualifications

As the Medicare Specialist, you are responsible for all aspects of Medicare receivable processing, including but not limited to billing, collection, account and system maintenance, process reconciliation, and productivity reporting.

What you will do in this role:

• Maintains current knowledge of all office operations, job specific requirements and related regulations
• Reviews all claims for completeness, reasonableness of charges, and appropriateness of billing codes, and payer information
• Pursues timely collection of each claim using thorough follow-up efforts appropriate to each payer
• Contacts and effectively communicates with all parties involved in the resolution of accounts placed
• Completes work request timely and in accordance with instruction
• Performs all tasks necessary to maintain current and accurate account information in each of the appropriate systems (i.e. entering notes, claims on hold)
• Maintains department daily productivity goals in completing a set number of accounts while also meeting quality standards as determined by leadership
• Provides support for team members that may be absent or backlogged
• Analyzes, investigates, and resolves outstanding edits in order to submit clean claims to Medicare
• Performs appropriate non-billable adjustments and plines as necessary
• Brings problems and troubling accounts, as well as related questions, to his/her immediate supervisor’s attention daily

What qualifications you will need:

• 1 year in a productivity/quality-based role or direct office experience preferred.

Benefits

Parallon, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive benefitsfor medical, prescription drug, dental, vision, behavioral health and telemedicine services
• Wellbeing support,including free counseling and referral services
• Time away from workprograms for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
• Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
• Education supportthrough tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
• Additional benefitsfor fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts

Learn more about Employee Benefits

Note: Eligibility for benefits may vary by location.

Parallon provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities.

HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated 3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.