Remote Medicare Billing & Claims Specialist

QHR Health; United States; Remote; USD 65,000 - 85,000; Full time

Job summary

Ovation Healthcare, formerly QHR Health, seeks a Medicare Specialist to manage billing and collections for Medicare patients from a remote location in the United States. Responsibilities include processing claims, resolving denials, and coordinating with Medicare representatives to ensure compliant reimbursement.

You will analyze complex billing data, maintain HIPAA-compliant records, and support appeals with accurate documentation across departments.

Qualifications

• 3–5 years of hospital business office billing and Medicare follow-up experience.
• In-depth knowledge of Medicare billing codes, guidelines, and regulations.
• Familiarity with EHR systems, billing software, and remittance advice processing.

Responsibilities

• Prepare and submit accurate Medicare claims, ensuring compliance with guidelines.
• Review accounts and reconcile payments with remittance advice; address patient questions.
• Investigate denied/underpaid claims and submit appeals with supporting docs.
• Monitor aging reports and prioritize overdue follow-up actions.
• Ensure billing practices comply with Medicare, HIPAA, and company policies.
• Maintain thorough records of claims, payments, and communications.

Skills

Medicare billing

DDE/CWF

EHR systems

HIPAA compliance

Communication

Analytical skills

Detail-oriented

CPT/ICD knowledge

Education

High school diploma or equivalent

Tools

DDE

CWF

Job description

Ovation Healthcare, formerly QHR Health, seeks a Medicare Specialist to manage billing and collections for Medicare patients from a remote location in the United States. Responsibilities include processing claims, resolving denials, and coordinating with Medicare representatives to ensure compliant reimbursement.

You will analyze complex billing data, maintain HIPAA-compliant records, and support appeals with accurate documentation across departments.