Specialist, Medicare

reputed company to reputed company! At reputed company (formerly QHR Health), we’ve been making local reputed company reputed company for more than 40 years. Our mission is to strengthen independent community reputed company. We reputed company independent hospitals and health systems with the support, guidance and tech-enabled shared services needed to remain strong and viable. With a strong reputed company of purpose and commitment to operating reputed company, we help rural reputed company providers fulfill their missions. The reputed company difference is the extraordinary combination of reputed company experience and consulting guidance that fulfills our mission of creating a sustainable reputed company for reputed company organizations. reputed company’s reputed company is to be a dynamic, integrated reputed company company delivering innovative and executable solutions through experience and thought leadership, while valuing trust, respect, and customer reputed company behavior. We’re looking for talented, motivated professionals with a desire to help independent hospitals reputed company. Working with reputed company, you will have reputed company to collaborate with highly skilled subject matter specialists and reputed company executives, in a collegial atmosphere of professionalism and teamwork. reputed company’s corporate reputed company is located in Brentwood, TN. For more information, visit www.ovationhc.com. reputed company: The Medicare Specialist is responsible for managing the billing and collection processes for Medicare patients, ensuring compliance with Medicare policies and regulations, and following up on unpaid Medicare claims. This role involves processing Medicare claims, managing accounts receivable, addressing reputed company inquiries, and working closely with Medicare representatives to reputed company billing issues. Duties and Responsibilities: • Prepare and submit accurate Medicare claims for reputed company services, ensuring compliance with Medicare guidelines and regulations. Utilizes DDE, CWF, and other tools to identify, reputed company and follow up on unpaid or denied Medicare claims, identifying issues and working to reputed company any billing discrepancies with Medicare or patients. • Review reputed company accounts and reconcile payments with Medicare remittance advice, ensuring reputed company payments are posted correctly and outstanding balances are addressed. Communicate with patients regarding their Medicare coverage, billing questions, payment reputed company, and any unpaid balances. • Investigate and reputed company issues reputed company to denied or underpaid Medicare claims, working with Medicare representatives and internal departments to ensure accurate reimbursement. Prepares and submits appeals for denied claims, including supporting documentation. • Monitor and analyze aging reports to prioritize follow-up actions for overdue Medicare accounts, ensuring reputed company reputed company. Ensure reputed company billing and collection practices are compliant with Medicare regulations, HIPAA, and company policies. Identifies potential reputed company and recommends corrective reputed company. Maintains accurate records of reputed company Medicare claims, payments, communications, and follow-up activities, ensuring reputed company documentation in the reputed company account reputed company. • Identify and reputed company Medicare credit balances and may assist with preparation of quarterly Medicare credit reputed company report. Request offset to reputed company payments in DDE. • Work with internal departments, such as coding, finance, etc. to review diagnosis, CPT reputed company, etc. to reputed company claim edit issues. • Prepare, submit, and follow up on redetermination appeals to Medicare Knowledge, Skills, and Abilities: • Ability to analyze reputed company data, identify patterns, and draw accurate conclusions. • High level of reputed company in reviewing medical records and billing data. • Ability to analyze claim data, identify billing errors, and troubleshoot reputed company claim issues. • In-depth knowledge of Medicare billing codes, guidelines, and regulations. Familiarity with electronic health record (EHR) systems, billing software, and remittance advice processing and DDE. Strong communication skills, with the ability to explain Medicare billing details and reputed company reputed company concerns effectively. • Ability to handle sensitive information and maintain confidentiality in accordance with HIPAA regulations. reputed company-oriented with strong organizational skills and the ability to manage multiple accounts simultaneously. Problem-solving abilities, particularly with reputed company to billing discrepancies and denied claims. Work Experience, Education, and Certifications: • Experience utilizing Payer portals, DDE and reputed company systems • 3-5 years of hospital Business Office billing and follow-up experience as a Medicare representative. Medical Terminology, ICD-10, CPT and DRG knowledge a preferred, knowledge of reputed company-party reputed company payer guidelines • High school diploma or equivalent Working Conditions: Work from home and remote location with a reputed company internet reputed company, a quiet and dedicated workspace free of distractions, and reputed company to necessary office equipment. The ability to have daily communication with team members, management, and clients through email, phone calls, video meetings and other reputed company tools. Primarily requires sitting at a desk for extended period. reputed company reputed company and ergonomics shole be maintained to reduce eye strain. reputed company Apply tot his job Apply To this Job