Inpatient Medicare Collection Specialist

Join Us as Inpatient Medicare Collections Specialist!

Full Time 40 hours onsite in Auburn, MA

The Inpatient Medicare Collections Specialist is responsible for maximizing reimbursement and ensuring timely resolution of Medicare inpatient accounts receivable. This role focuses on Medicare fee-for-service claims, including high-dollar hospital stays, by managing claim edits, resolving denials, and navigating the Medicare Direct Data Entry (DDE/FISS) system to secure accurate and timely payment.

Inpatient Medicare Collections Specialist Job Responsibilities:

• Monitor Medicare DDE (FISS) system for claim status updates including edits, RTP, and suspended claims.
• Correct claim errors, billing discrepancies, and coding-related issues.
• Investigate and resolve denied, zero-pay, or underpaid Medicare claims.
• Prepare and submit redetermination and reconsideration appeals.
• Work Medicare aging reports daily and prioritize high-dollar accounts.
• Communicate with Medicare Administrative Contractors (MACs) to resolve claim issues.
• Coordinate patient responsibility and secondary billing.
• Ensure compliance with CMS regulations and proper documentation.
• Other Collections activity as assigned

Inpatient Medicare Collections Specialist will have the following:

• 13+ years of hospital billing or Medicare collections experience.
• Inpatient Psych experience preferred.
• Experience with Medicare DDE/FISS preferred. Knowledge of Medicare billing rules and IPPS
• Familiarity with Medicare Secondary Payer (MSP) rules
• Strong analytical and detail-oriented skills
• Proficiency in billing systems and Microsoft Office

When you join the growing TaraVista team, you're not just taking a job, you're making a difference in people's lives. As our team member, you'll receive:

• Medical, Dental, and Vision
• 401(k) match
• Employer paid short term disability (STD)
• Employer paid life and AD&D Insurance
• Generous Paid Time Off
• Flexible Spending Account
• Tuition Reimbursement

Pay Range

Compensation will be determined based on the candidate's relevant experience.

$24.00 - $30.00

TaraVista is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.