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Medicare Billing Specialist

Philadelphia, PA

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Fast growing, employee centric organization has an exciting opportunity for a Medicare Billing Specialist in our Philadelphia office. The primary responsibilities of this position includes the accurate and timely submission and resolution of claims to Medicare. Essential Duties and Responsibilities: • Prepares documentations and processes computer input of patient accounts to ensure timely follow-up. • Reviews diagnosis, procedure codes, and charges for accuracy and obtains from appropriate department when necessary. • Verifies patient eligibility using appropriate systems, and checks system for possible overlap claims. • Requests additional insurance information and assignments from patients. • Copies appropriate insurance information to submit with billing. • Updates insurance information and Financial Class. • Processes and submits Medicare difficult claims; exhausted benefits, Part B claims to the appropriate intermediary to ensure accurate and prompt reimbursement of charges. • Responds to Medicare ADR, RAC and other CMS requests. • Sends all necessary information and documents to payer. • Processess complete and timely claim follow-up as required to ensure claims are adjudicated in shortest amount of time, 14 business days. • Responsible for electronic error/reject reports worked accurately each day. • Completes weekly explanation of Aged A/R. • Performs other duties as necessary to assist in the functioning of the department. Specifications: Education & Experience Requirements: • High school diploma or GED required. • Two years of college or equivalent work experience preferred. • Two years of recent Medicare Account Receivable responsibility. Thorough knowledge of all aspects of Medicare rules and regulations as it relates to claims submission. Skills and Abilities: • Knowledge of medical terminology is a plus. • Understanding of CPT, ICD10 and HCPCS codes • Good typing ability • Familiar with the 10-key calculator • Excellent math skills We offer a competit

Job Requirements

1-2 Years of Medical Billing and Medicare/Medicaid experience

Input patient accounts, review diagnosis, procedure codes and charges for accuracy

Verify eligibility

Process and submits Medicare claims, review exhausted benefits, Part B claims etc.

Respond to Medicare ADR, RAC and CMS requests

Experience with CPT, ICD10 and HCPCS codes


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