Medicare Specialist

CorroHealth Inc; Illinois; Hybrid; USD 45,000 - 65,000; Full time

Job summary

CorroHealth Inc. is seeking Medical Reimbursement Specialists to collaborate with insurance carriers and patients to resolve outstanding balances through research, follow ups, and appeals. This is a REMOTE POSITION and applicants must reside in the United States.

Key duties include editing Medicare claims, following up on billed claims, and maintaining knowledge of Medicare guidelines. The role requires familiarity with CPT/ICD-10 coding and insurance billing processes, with opportunities to

Qualifications

• Two years experience resolving medical Medicare claims.
• Knowledge of Medicare/Medicaid payors.
• Familiarity with CPT and ICD-10 coding.
• Knowledge of insurance billing and medical terminology.
• Familiarity with electronic and paper systems used in billing healthcare services.
• Ability to research unpaid or underpaid claims for resolution.

Responsibilities

• Edit and perform maintenance on Medicare claims.
• Follow-up on billed claims in a timely and effective manner.
• Maintain knowledge of current Medicare regulations and guidelines.
• Monitor patient accounts for accurate payment.
• Pursue account reimbursement through compliant action.
• Edit rejected claims in DDE which are identified on RTP report.
• Review patient bills for accuracy and completeness and obtaining any missing information.
• Utilization and adherence to Medicare guidelines.
• Other duties as assigned.

Skills

Medicare claims experience

Medicare/Medicaid payors

CPT and ICD-10 coding

Insurance billing knowledge

Medical terminology

Research unpaid/underpaid claims

Education

High School Diploma or GED

Job description

About Us

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs. Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals. We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success.

Job Summary

Medical Reimbursement Specialists work with insurance carriers and patients to resolve outstanding balances through research, follow ups and appeals.

This is a REMOTE POSITION. Must live in the US.

Essential Duties and Responsibilities

• Edit and perform maintenance on Medicare claims.
• Follow-up on billed claims in a timely and effective manner.
• Maintain knowledge of current Medicare regulations and guidelines.
• Monitor patient accounts for accurate payment.
• Pursue account reimbursement through compliant action.
• Edit rejected claims in DDE which are identified on RTP report.
• Review patient bills for accuracy and completeness and obtaining any missing information.
• Utilization and adherence to Medicare guidelines.
• Other duties as assigned.
• This is a REMOTE POSITION.
• Must live in the US.

Minimum Qualifications & Requirements

• High School Diploma or GED equivalent
• Two years (2) experience resolving medical Medicare claims
• Knowledge of Medicare and/or Medicaid payors
• Familiarity with CPT and ICD-10 coding preferred
• Knowledge of insurance billing and medical terminology preferred
• Familiarity with electronic and paper systems used in billing healthcare services
• Ability to research unpaid or underpaid claims for resolution

Physical Demands

Note: Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described. Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required. At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs. Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines. A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.

CorroHealth sits at the center of the revenue cycle revolution. Fundamental operations of the revenue cycle are supported through our expert teams while we recast the role of clinicians through automation. This shift to a true clinical revenue cycle helps us achieve our core purpose - exceed client financial health goals. For each patient population, CorroHealth automates key clinical aspects of the cycle. Our platforms focus on capture and application of clinical documentation while easing the burden on physicians. Scalability is prioritized in the support of client program operations. As with most revenue cycle partners, our skilled and enthusiastic team is available to outsource any portion of the cycle. However, we can also complement client programs with additional expert support or upskill existing client teams to meet program demands. Whether our team is deployed directly, or automation is incorporated for a more programmatic solution, CorroHealth delivers. CorroHealth has acquired Xtend Healthcare! For more information, please visit https://corrohealth.com. Applicants will only receive job-related emails from the domain @corrohealth.com. Additionally, it is important to emphasize that CorroHealth will never ask for money in return for a job offer.