Medicare Coordinator I

About the Role

Performs billing collection functions for Medicare account receivables, keeping accounts to a minimum and cash flow to a maximum. Reviews and processes electronic claims, analyzes and corrects claims via AccessANYware, SSI, and DDE software systems to ensure timely reimbursement. Problem solves RTP and denied claims and provides support/maintenance for the electronic Medicare billing system. Responsible for the coordination and updating of the CM and DDE billing updates, billing tables, and system edits to maximize electronic capability. Runs job streams, generates and evaluates electronic Medicare billing reports. Provides education and training to staff on electronic claims submissions. Stays current on Medicare billing regulations and compliance issues. Responds to incoming calls and walk-in patients.

Responsibilities

• Review and process electronic Medicare claims
• Analyze and correct claims using AccessANYware, SSI, and DDE software
• Resolve RTP and denied claims
• Maintain and update CM and DDE billing systems, tables, and edits
• Run job streams and generate Medicare billing reports
• Train staff on electronic claims submissions
• Stay updated on Medicare billing regulations and compliance
• Respond to patient inquiries via phone and in-person

Requirements

• Minimum of four (4) years of Patient Financial Services experience
• Two (2) years of experience in Medicare billing and collections (or an Associate's degree/higher in lieu of this experience)
• High School Diploma, GED, or equivalent certificate

Preferred Qualifications

• Two (2) years of experience with Windows-based software applications
• Certified Patient Account Technician (CPAT) or Certified Revenue Cycle Specialist (CRCS) certification
• Ability to analyze problems and follow through to resolution
• Strong interpersonal skills for handling difficult situations diplomatically
• Working knowledge of ICD-10 and CPT coding
• Typing speed of at least 45 words per minute

Schedule

Full-time, Monday through Friday, 40 hours per week with a flexible start time between 7:00 AM and 9:00 AM. Position is on-site at the Support Services location with no remote availability at this time.

Employment Screening

As part of Sarasota Memorial Health Care System’s commitment to safety, all individuals providing care to vulnerable populations must undergo background screening through The Florida Care Provider Background Screening Clearinghouse.