Responsible for the compliant, accurate, and timely billing and follow-up of hospital Medicare and Medicare Advantage patient accounts.
The role includes submitting Medicare and Medicare Advantage claims, resolving billing edits and claim rejections, following up on unpaid or unprocessed claims, communicating with payers and internal departments, and maintaining accurate documentation in billing systems. The position also supports credit balance review, complex claim handling, special projects, and revenue cycle analysis to improve clean claim rates, reimbursement, and overall department workflow.
Must have at least 3 years of direct Medicare hospital billing and follow-up experience and 5 years of experience working with hospital claims across multiple payer types, including Medicare, Medicaid, commercial, and managed care.
Preferred qualifications include:
- CRCS certification or college degree in healthcare or a business-related field
- Strong knowledge of Medicare, Medicare Advantage, Medicaid, commercial, and managed care billing
- Experience with ICD-10, CPT-4, HCPCS, MSP, TPL, ABN requirements, and Medicare regulations
- Understanding of LCD, NCD, CMS publications, transmittals, and change requests
- Ability to work independently, analyze billing data, and resolve complex claim issues
- Strong documentation, communication, customer service, and compliance skills
- Familiarity with hospital systems such as Epic HB, OnBase, DataArk, and MedAssets
- CRCS certification required upon hire or within 12 months
Location
Chesapeake, Virginia, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
1 month ago