About IKS Health www.ikshealth.com
Job Description
The Medicare Biller is responsible for the compliant, accurate and timely billing of all hospital Medicare and Medicare Advantage (Medicare HMOs) patient accounts. The position requires a strong understanding of Medicare billing processes and the ability to manage multiple tasks effectively. This role involves identifying and correcting errors to ensure prompt payment of outstanding accounts. Must have working knowledge of Medicare and the complex regulations concerning Medicare reimbursement. Strong customer service, good verbal and written communication, analytical skills to be able to ensure compliance with Medicare regulations and guidelines, maintain accurate records, and communicate effectively with various stakeholders.
Essential Duties and Responsibilities
Duties and responsibilities described represent the general tasks performed on a daily basis but not limited as other tasks may be assigned.
Generate and submit claims, both electronic and paper claims (UB-04 and HCFA-1500) to Medicare and Medicare Advantage (Medicare HMOs), ensuring they adhere to billing guidelines and regulations and that they capture all charges and needed element to ensure prompt payment.
Review patient financial records and/or claims prior to submission to ensure payer-specific requirements are met.
Review unreleased claims daily in order to resolve and release to the payer.
Review daily electronic billing reports, paper claim submissions, and third-party confirmation reports for errors.
Resolve claim edits based on documented processes in the electronic billing system.
Complete secondary claim releases daily.
Submit shadow bill (IME/Information only claims) to Medicare.
Process Medicare Return to Provider (RTP) claims and denial reports on a daily basis.
Ability to analyze claims data and identify discrepancies or errors and make necessary corrections in the billing system to ensure accurate claims.
Understand how to resolve Medicare/Medicare MA billing edits and/or warnings and billing edits that are identified in the Patient Accounting Billing System.
Keep abreast of Medicare/Medicare MA government requirements and regulations and ensure all billing practices adhere to these standards.
Experience and Knowledge
Experience: 2-5 plus years in a hospital setting with at least 1 year background in Medicare and Medicaid hospital billing and follow-up functions required.
Experience with electronic health records and medical billing software.
Must exhibit very strong analytical and compliance issues skills.
Knowledge of hospital billing requirements; Medicare and Medicaid billing rules, regulations, and deadline (Understands the billing and payment follow up time limits set forth by Medicare).
Knowledge of revenue cycle management best practices.
Ability to manage multiple tasks effectively and efficiently.
Compensation and Benefits
The pay range for this position is $18 to $22 per hour. Pay is based on several factors, including but not limited to current market conditions, location, education, work experience, certifications, etc.
IKS Health offers a competitive benefits package including healthcare, 401(k), and paid time off (all benefits are subject to eligibility requirements for full-time employees).
IKS Health is an equal opportunity employer and does not discriminate based on race, national origin, gender, gender identity, sexual orientation, protected veteran status, disability, age, or other legally protected status.