Revenue Cycle Medical Billing Appeal Medicare Follow-Up Specialist - Located in West Plains, MO

Location: Remote or On-Site (West Plains, MO)

About the role

The Revenue Cycle Medical Billing – Appeal – Medicare Follow-Up Specialist will follow-up on appeal status with traditional Medicare and Medicare Advantage plans in a timely manner to achieve maximum reimbursement on zero and under paid claims.

Responsibilities

• Conduct online and phone follow-up on pending appeal responses.
• Process all payor responses received from submitted appeals.
• Handle inbound/outbound call center calls for payors and patients/guarantors.
• Meet daily and monthly departmental production goals set forth by the supervisor.
• Identify, document and communicate trends in recurring denials.
• Recommend process improvements or system edits to eliminate future denials or delays in reimbursement.
• Document all account activity in an accurate and timely manner for all touches made on any patient account.

Requirements

• Must be fluent in English
• Minimum three (3) years of experience in healthcare/revenue cycle billing environment
• Above average knowledge of CMS guidelines
• Ability to interpret remittance advice notices/explanation of benefits
• Minimum of one (1) year in a call center environment
• Knowledge and experience of computers and related technology, at an intermediate level

Qualifications

Preferred Experience:

• Appeal experience
• Proficient in Word, Excel, Office 365

Preferred Education:

• High school diploma
• GED
• Or significant, relevant work experience

Skills

• Ability to calculate numbers, correct entries, and post to records
• Ability to gather data, compile information, and prepare reports
• Ability to use independent judgment and to manage and impart confidential information
• Ability to prepare routine administrative work
• Skilled for records maintenance
• Knowledge of health care billing compliance regulations (intermediate)
• Knowledge and understanding of payor Explanation of Benefits (intermediate)
• Excellent internal and external customer service skills

Pay

Hourly Compensation: $18 (this position is bonus eligible)

Schedule

Full-Time

Benefits

Check out our careers site benefits page to learn more about our benefit options.