Medicare Collections Representative

Job Title: Sr. Revenue Cycle Specialist: Medicare Collections
Location: Fully Remote
Duration: 6 months

Top Skills: Medicare Collections, Problem Solving, Communication
Candidates with a strong background in insurance collections, particularly with Medicare collections experience.
The role will primarily focus on claim work, payment reconciliation, identifying trends, and operating effectively in a fast-paced environment.
Strong problem-solving skills, the ability to perform root cause analysis, and a proactive approach to driving process efficiencies are essential.

ESSENTIAL DUTIES AND RESPONSIBILITIES:
Research, initiate follow-up, and resolve all unpaid or underpaid system debit balances on Medicare insurance claims; includes but is not limited to remit review, calling payer(s) and clinics, rebilling, navigating payer portals, and taking adjustments
Uses critical thinking, problem-solving and analytical skills to determine the root cause of our underpayment and follow appropriate policy and procedure to remediate
Navigate through various payer systems and multiple internal systems to ensure timely and accurate resolution of Medicare claims
Uses exceptional organization, written, and verbal communication skills to produce detailed documentation of research and actions taken on claims
Ad hoc monthly reporting of outstanding debit balances and trends
Stay current on communication relating to healthcare reimbursement and regulatory changes
Develop and maintain positive working relationships with clinical personnel, teammates, and payer representatives
Works well under pressure in a fast-paced environment and meets expectations of deadlines, and carries out assignments to completion while maintaining a positive attitude
Maintain confidentiality of all company and patient information in accordance with HIPAA regulations.
Consistent and punctual attendance as scheduled is an essential responsibility of this position

Skills:
3+ years of Medicare Experience (required)
2+ years of experience with generic accounting, transactions, or medical billing systems (preferred)
Healthcare and medical billing/collections/denial remediation experience (required)
Intermediate computer proficiency in Microsoft Office tools including Excel, PowerPoint and Outlook (preferred)