Medicare Specialist

CorroHealth Inc; United States; Remote; USD 40,000 - 60,000; Full time

Job summary

CorroHealth Inc. in the United States is seeking a Medical Reimbursement Specialist to resolve outstanding balances with insurance carriers and patients through research, follow-ups, and appeals. This is a remote role, and you must reside in the US.

The position focuses on Medicare claims, timely follow-ups, and accurate billing knowledge. You will edit and pursue reimbursements while staying current with Medicare guidelines and payer requirements.

Qualifications

• High school diploma or GED required.
• 2 years of experience resolving 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 billing systems.
• Ability to research unpaid or underpaid claims for resolution.

Responsibilities

• Edit and maintain 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 identified on RTP report.
• Review patient bills for accuracy and missing information.
• Utilization and adherence to Medicare guidelines.
• Other duties as assigned.

Skills

Medicare claims

Medicare payors

CPT ICD-10 coding

Insurance billing

Medical terminology

Electronic systems

Research unpaid 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:

Note: The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties. This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.

• 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.

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.

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.