Job Description

Job Description

Job Description

Medicare Biller Remote/Hybrid

Position Summary:

The Medicare Biller is responsible for ensuring accurate reimbursement for services by submitting complete and accurate claims. Under the direct supervision of the Government Billing Manager, this individual utilizes their Medicare knowledge to effectively resolve any claim edits or rejections to ensure timely receipt by claims processor, thereby promoting maximum reimbursement for our organization.

Principal Duties and Responsibilities:

• Claims Submission: Prepare and submit clean electronic or paper claims to Medicare in accordance with federal guidelines and payor requirements
• Verification: Verify patient eligibility before submitting claim
• Denial Prevention: Review claim edits within both EHR and claim scrubber software and resolve or forward to appropriate personnel for resolution
• Claim Rejections: Monitor DDE system for claim rejections and make necessary adjustments with both EHR and DDE to resolve or communicate to appropriate personnel, depending on defined guidelines
• Claim Monitoring: Monitor claims to ensure receipt by Medicare
• Patient Communication: Communicate with patient as needed to verify and/or update payor information
• Other job duties as assigned.

The above statements reflect the general duties considered necessary to describe the principal functions of the job as identified and should not be considered a detailed description of all the work requirements that may be inherent to the position.

Knowledge, Skills and Abilities:

• Knowledge of the following:
  • Medicare Billing Guidelines
  • Medicare Secondary Payor (MSP) Guidelines
  • DDE System
  • Optum Assurance Reimbursement Software
  • Hospital Medicare Billing Process
  • Critical Access Medicare Billing
  • Professional Medicare Billing
  • Revenue Cycle workflow
  • EHR (Electronic Health Record) software systems.

• Attention to detail
• Ability to work independently
• Ability to multitask and manage time effectively.
• Excellent communication skills.

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