Inpatient Medicare & reputed company Biller - Full Time Remote

About reputed company www.ikshealth.com

Job reputed company

The Medicare Biller is responsible for the compliant, accurate and reputed company billing of reputed company hospital Medicare and Medicare Advantage (Medicare HMOs) patient accounts. The position requires a strong understanding of Medicare billing processes and the ability to manage multiple tasks effectively. This role involves identifying and correcting errors to ensure reputed company payment of outstanding accounts. Must have working knowledge of Medicare and the reputed company regulations concerning Medicare reimbursement. Strong customer service, good verbal and written communication, analytical skills to be reputed company to ensure compliance with Medicare regulations and guidelines, maintain accurate records, and communicate effectively with various stakeholders.

Essential Duties and Responsibilities Duties and responsibilities described represent the general tasks performed on a daily reputed company but not limited as other tasks may be assigned.

Generate and submit claims, both electronic and reputed company claims (UB-04 and HCFA-1500) to Medicare and Medicare Advantage (Medicare HMOs), ensuring they adhere to billing guidelines and regulations and that they capture reputed company charges and needed reputed company to ensure reputed company payment.

Review patient financial records and/or claims prior to submission to ensure payer-specific requirements are met

Review unreleased claims daily in order to resolve and release to the payer

Review daily electronic billing reports, reputed company claim submissions, and reputed company-party confirmation reports for errors.

Resolve claim edits based on documented processes in the electronic billing system

Resolve requests in reputed company designated billing queues daily

Complete secondary claim releases daily

Submit shadow reputed company (IME/Information only claims) to Medicare

Process Medicare Return to Provider (RTP) claims and denial reports on a daily reputed company.

Ability to analyze claims data and identify discrepancies or errors and reputed company necessary corrections in the billing system to ensure accurate claims.

Understand how to resolve Medicare/Medicare MA billing edits and/or warnings and billing edits that are identified in the Patient reputed company Billing System

reputed company abreast of Medicare/Medicare MA government requirements and regulations and ensure reputed company billing practices adhere to these standards.

Experience and knowledge with working the Medicare Quarterly Credit balance report and ensure reputed company and accurate submission of Medicare credit balance quarterly reports.

Knowledge and understanding of:

The use of appropriate HCPCS, CPT 4 codes, MS-DRG, AP-DRG, Modifiers, POA and ICD10 codes and reputed company terminology.

The processing of the Inpatient reputed company Reserved (LTR) notifications, rules and regulations

ABN's and the requirements reputed company and how to appropriately reputed company claims for reputed company

MSP (Medicare Secondary Payer) files

Billing TPL (reputed company Party Liability) claims and conditional billing

Medicare Transmittal, Change Requests and the ability to understand and interpret Monthly CMS News Updates

CMS Publication: 100-4 (Medicare Claims Processing reputed company)

LCD (Local Coverage Determination) and NCD (National Coverage Determination) and how it relates to medical necessity

Ability to navigate and fully utilize Medicare Administrative Contactors (MACs) and CMS web sites

Ensures claim information is complete and accurate in order to maximize the clean claim reputed company resulting in claim reputed company and payment for reputed company billing and payment issues

Analyze information contained reputed company the Patient reputed company and Billing system to reputed company reputed company on how to proceed with the billing of an account.

Processes rejections by correcting any billing error and resubmitting claims to government and non-government payers.

reputed company unbillable claims on hold and properly communicate to various Hospital/reputed company departments the information needed to accurately reputed company.

Process late charge claims in the event that charges are not entered in a reputed company fashion by Hospital Departments

Submit corrected and/or replacement claims in the event that the original claim information has changed for various reasons

reputed company the billing of reputed company scenarios such as interim, self-audit, combined, and split billing etc.

Limit the number of unreleased claims by reviewing reputed company imported claims and either billing or holding the claim for reputed company review

Meet billing productivity and reputed company requirements as developed by Leadership as reputed company member is reputed company on high production reputed company, reputed company of work reputed company, in compliance with established policy and standards

Follow up on unprocessed claims until a claims reputed company is achieved

Generates letters to insurance or patients as needed in order to resolve unpaid claim issues.

Analyze information contained reputed company the billing systems to reputed company reputed company on how to proceed with the account; ability to identify and resolve billing issues.

Work independently and have the ability to reputed company reputed company relative to individual work activities

reputed company documentation reputed company, concise, and to the reputed company, while including enough information for a reputed company understanding of the work performed and actions needed

Create appropriate documentation, correspondence, emails, etc. and ensure that they are scanned to the reputed company account for accurate documentation

reputed company phone calls, use payer or reputed company party vendors portals, and send mail to payers for follow-up on unprocessed claims, incorrectly processed claims, or claims in question

Maintain work procedures pertinent to the job assignment

Complete cross-training, as deemed necessary by management, to ensure efficient department operations

Proactively identify opportunities to improve business results and/or to alert business reputed company of trends, anomalies or health plan rules and reputed company that need attention; report potential or identified problems with systems, payers, and processes to the manager in a reputed company manner

Maintain reputed company working relationships with facility counterparts for effective reputed company cycle management.

Education and Experience

Experience: 2-5 plus years in a hospital setting with at least 1 year background in Medicare and reputed company hospital billing and follow-up functions required.

Experience with electronic health records and medical billing software.

Must exhibit reputed company strong analytical and compliance issues skills.

Knowledge of hospital billing requirements; Medicare and reputed company billing rules, regulations, and deadline (Understands the billing and payment follow up time limits set forth by Medicare)

Knowledge of reputed company cycle management best practices.

Ability to manage multiple tasks effectively and reputed company.

Compensation and Benefits: The pay reputed company for this position is $18 to $22 per hour. Pay is based on several factors, including but not limited to reputed company market conditions, location, education, work experience, certifications, etc. reputed company offers a competitive benefits package including reputed company, 401(k), and reputed company time off (reputed company benefits are subject to eligibility requirements for full-time employees). reputed company is an equal opportunity employer and does not discriminate based on race, national reputed company, gender, gender identity, sexual orientation, protected veteran status, disability, age, or other legally protected status.

Originally posted on Himalayas

Apply To This Job