Business Office/Clerical

Medicare Billing Specialist - FT

Under the direction of the Director of Patient Financial Services the Medicare Billing Specialist verifies charges and Medicare/insurance information, releases Medicare and MSP claims electronically, sends hard copy claims if appropriate, follows up on all unpaid claims. Works Medicare On-Line system, past due reports, rejection reports, Medicare information requests.

 

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following:

  • Effectively present information and respond to questions from groups of managers, staff members, patients, and patient families, outside agencies and the general public

  • Daily billing of Medicare/MSP claims

  • Verifies all Medicare and Insurance information and checks each bill for correctness of charges on a daily basis.           

  • Make necessary changes by working with departments throughout the hospital and the Medicare on-line-system.

  • Bills electronically all claims that are eligible

  • Bills Hard copy all claims that are not eligible for electronically remittance.

  • Shares responsibility-downloading claims into the Electronic Billing System from the main computer in addition to transmission of claims

  • Responsible for follow-up of all the above claims     

  • By using daily report follows up on the entire above Medicare, MSP, Secondary insurance claims within a 45-day period.

  • Makes all necessary Medicare corrections on the Medicare-On Line System

  • Requests Medical records on all requests from HCFA , and makes sure they are sent in a timely manner.

  • Sends in appeals when appropriate for hospital or patients

  • Makes adjustments when necessary to all Medicare claims

  • Weekly works Medicare report for timely payment of claims 

  • Consistently works the Medicaid Reject remittance for the corrections of these claims and possible resubmission.

  • Reviews, research, and resolve all Medicare Credit Balance

  • Responsible for the Quarterly Medicare Credit Balance Report; Pulls all Credit balances from a report, and reports to the Patient Accounts Director for submission of information to HCFA

  • Other duties may be assigned



E/R REGISTRATION CLERK - FT

FT E/R REGISTRATION CLERK.