Revenue Cycle Medical Billing Appeal Determination - Medicare

Revenue Cycle Medical Billing Appeal Determination - Medicare

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

Hourly Compensation: $18

(this position is bonus eligible)

Schedule: Full-Time

The Revenue Cycle Medical Billing Appeal Determination - Medicare position is responsible for reviewing incorrectly processed and/or denied claims to determine next appropriate actions to resolve the claim.

Essential Functions/Duties

• Process remittance advice notices from Medicare claims (primary, secondary, tertiary) to determine next actions.
• Obtain and document necessary reprocessing and/or appeal related data to resolve the incorrectly processed/denied claim in a timely and efficient manner.
• Determine process and resources are allocated to provide required payor documentation, assembly, and filing in a timely manner.
• Analyze work processes to maximize efficiency.
• Work to achieve team and departmental goals.
• Work effectively as a member of a team.
• Communicate clearly and concisely, both orally and in writing.

Qualifications

Required Experience:

• Must be fluent in English
• Minimum three (3) years' experience in healthcare/revenue cycle billing environment (medical billing)
• Above average knowledge of Medicare and/or Medicare Replacement billing guidelines
• Ability to read and decipher an explanation of benefits and/or remittance advice notice
• Minimum of one (1) year working in a call center environment
• Ability to work independently or as an active member of a team
• Must possess empathic and professional written and verbal communication skills
• Knowledge and experience of computers and related technology, at an intermediate level

Preferred Experience:

• A minimum of one (1) year working in customer service

Preferred Education:

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

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