Medicare Billing Specialist

Medicare Billing SpecialistWe are looking for a motivated performer to join the Centralized Training Office as a Hospital Billing Specialist focused on Medicare. We are looking for a top performer with extensive knowledge of billing processes. Reporting to the Billing Manager, the Hospital Billing Specialist, Medicare is responsible for the timely and accurate submission of claims ensuring those claims result in maximum reimbursement. This will encompass services rendered in an Acute Care Surgical Hospital setting.Responsibilities:Pull any preoperative notes from the designated transcription company.Extract information from medical records, operative notes, invoices, progress notes and discharge paperwork to ensure completeness and accuracy of charge entry.Capture implants, high-cost supplies, high-cost drugs, post op pain blocks and observations times prior to charge submissionReview accuracy of invoice details, including customer billing instructions, pricing, discounts, state sales tax, etc.Execute the recurring billing workflow and generate and transmit claims daily.Ensure timely follow-up and resolution of internal and external inquiries of billing issues (i.e., operative notes, POPM form, invoices, or implant pricing etc).Reconcile revenue and billing during the period-end close process.Complete accurate charge entry for all assigned cases and upload to designated electronic claims clearinghouse daily.Resolve claim rejections daily to ensure clean claims are transmitted and received by the appropriate payer.Investigate, appeal, and resolve denied or unpaid claims, ensuring correct resubmission and payment.Navigate the DDE and make the appropriate claims corrections when appropriate.Manage claim resubmission queues in a timely manner.Maintain current knowledge of health care billing laws, rules, regulations, and developments.Complete Special Projects when appropriate.Complete other duties as assigned.Required Skills:Experience in DDE system, Ability Ease, and Novitasphere3-4 years previous Hospital billing experience, with emphasis on Medicare billingPreference shown to previous experience in a Facility settingAbility to work independentlyExcellent communication skills and interpersonal skillsSkilled in time management and prioritization of emergent situationsComfortable utilizing critical thinking skillsProficient with Microsoft Office productsExperience with electronic patient information systemsFunction as a subject matter expert (SME) for MedicareExperience with Ability, DDE, nThrive, Cerner, etc required.