Medicare Specialist

About the role

This Work from Home position requires that you live and will perform the duties of the position within 60 miles of an HCA Healthcare Hospital (located in FL, GA, ID, KS, KY, MO, NV, NH, NC, SC, TN, TX, UT, VA).

Responsibilities

• Maintains current knowledge of all office operations, job specific requirements and related regulations
• Reviews all claims for completeness, reasonableness of charges, and appropriateness of billing codes, and payer information
• Pursues timely collection of each claim using thorough follow-up efforts appropriate to each payer
• Contacts and effectively communicates with all parties involved in the resolution of accounts placed
• Completes work request timely and in accordance with instruction
• Performs all tasks necessary to maintain current and accurate account information in each of the appropriate systems (i.e. entering notes, claims on hold)
• Maintains department daily productivity goals in completing a set number of accounts while also meeting quality standards as determined by leadership
• Provides support for team members that may be absent or backlogged
• Analyzes, investigates, and resolves outstanding edits in order to submit clean claims to Medicare
• Performs appropriate non-billable adjustments and plines as necessary
• Brings problems and troubling accounts, as well as related questions, to his/her immediate supervisor's attention daily
• Exercises good judgment and makes sound decisions in the absence of detailed instructions or in an emergency situation
• Treats client requests with a high priority. Quickly informs supervisor and any other personnel needed to help carry out the request timely, accurately, and according to instruction
• Strives to improve current operations by identifying inefficiencies and recurring problems, and by making suggestions to the immediate supervisor
• Promotes the Medicare Service Center and helps to identify necessary resources to meet customer needs

Qualifications

• High school graduate or equivalent preferred
• 1 year in a productivity/quality-based role or direct office experience preferred

Benefits

• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
• Wellbeing support, including free counseling and referral services
• Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
• Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
• Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
• Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts

This response is AI-generated, for reference only.