Medicare A/R Billing Representative

Responsibilities

• Follow up on unpaid and underpaid Medicare claims to ensure prompt resolution and reimbursement
• Analyze Explanation of Benefits (EOBs) and Remittance Advice (RAs) to identify discrepancies
• Investigate and resolve claim denials, rejections, and payment variances
• Submit corrected claims, appeals, and supporting documentation as needed
• Work aging reports and prioritize accounts based on timely filing limits
• Ensure compliance with Medicare regulations, coding guidelines, and payer policies
• Codes services provided utilizing CPT and ICD-10 coding
• Knowledge of Medical Terminology, ICD-10, CPT codes and the correct use of modifiers
• Working rejections from the clearinghouse to correct errors for resubmissions
• Generates and submits electronic claims and statements at designated intervals; corrects any errors for complete and accurate transmission of data
• Able to handle patient inquiries regarding billing issues, out of network issues, and explaining insurance guidelines to patients
• Read and analyze patient records to determine correct codes for billing to insurance provider
• Researches and processes refund requests and overpayments
• Prepares correspondence and/or collection letters
• Performs other related duties as assigned by senior management

Requirements

• Experience: 1 year

Qualifications

• Education: Less than High School