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Medicare Specialist

Elevate Patient Financial Solutions
Remote, USA
Full-time
Entry · 1+ years experience
Remote
Discovered 1 months ago
Medicare DDECMS.GovFISSICD-9ICD-10CPT

Full Job Posting

  • Resolve cash generating accounts expeditiously to bring in revenue for the client and the company.
  • Able to review Medicare claims to determine status (UB/HCFA)
  • Able to post adjustments on various facility systems
  • Must have the ability to work denials and appeals in a timely manner
  • Experience in billing electronic claims
  • Driven to resolve claims on first touch
  • Proficiently navigate through CMS.Gov websites as well as the intermediary websites
  • Working knowledge of ICD-9 and ICD-10, CPT, revenue codes, HCPCS and modifiers
  • Able to work in the Medicare DDE/FISS (Direct Data Entry) system: (Hospital only) Check Claim status in DDE Know the condition codes for adjusting and canceling claims Enter/correct/adjust/cancel claims Able to rekey a claim directly into the DDE system Make correction to RTP claims (returned to provider) Able to interpret eligibility information on CWF and HIQA Develops a solid understanding of assigned client processes in order to review and analyze claims and account receivable functions.
  • Check Claim status in DDE
  • Know the condition codes for adjusting and canceling claims
  • Enter/correct/adjust/cancel claims
  • Able to rekey a claim directly into the DDE system
  • Make correction to RTP claims (returned to provider)
  • Able to interpret eligibility information on CWF and HIQA
  • Develops a solid understanding of assigned client processes in order to review and analyze claims and account receivable functions.
  • Include key information in account notes consistently
  • Able to ask questions, if unclear, on facility specifics or company processes.
  • Able to use the appropriate reason and status codes in the company software for each account
  • Able to request the correct information from the appropriate entity when attempting to resolve the account.
  • Maintain the minimum production criteria for the various client assigned
  • Maintain a 5% or less error ratio
  • Regular and timely attendance.
  • Other duties as assigned.
  • High School Diploma or GED.
  • Some college preferred or college degree.
  • Minimum 1-2 years’ experience in working traditional Medicare claims.
  • Minimum of 1-2 years’ experience in working in DDE Direct Data Entry system.
  • Able to type 50 wpm
  • Team-oriented but also able to work independently
  • Strong organizational skills.
  • Excels at time-management.
  • Able to adapt to change.
  • Proven success at building strong working relationships with coworkers and management.
  • Beneficial to have worked in one or more Health Information Systems: Epic physicians or hospital, Meditech, Invision, AS400, Citrix, IDX, Nextgen, Allscript Physicians or hospital, Centricity, Soarian, Series & HBOC Star, Cerner, Practice Plus, TMHP and other Medicaid sites.
  • Remote and Hybrid positions require internet connections that meet the Company’s upload and download speed criteria.

• Medical, Dental & Vision Insurance

  • 401K (100% match for the first 3% & 50% match for the next 2%)
  • 15 days of PTO
  • 7 paid Holidays
  • 2 Floating holidays
  • 1 Elevate Day (floating holiday)
  • Pet Insurance
  • Employee referral bonus program
  • Teamwork: We believe in teamwork and having fun together
  • Career Growth: Gain great experience to promote to higher roles

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