Communication, Compliance & Specialized Billing • Communicate with revenue cycle departments to resolve claim discrepancies and obtain required documentation • Communicate with Medicare Administrative Contractors (MACs), fiscal intermediaries, TRICARE contractors, CHAMPVA representatives, and other governmental payer contacts • Maintain current knowledge of Medicare bulletins, CMS regulations, MAC updates, TRICARE guidelines, CHAMPVA requirements, and other governmental payer policies • Ensure compliant billing for CMS-qualified clinical trials and other specialized claims • Notify management of billing errors, reimbursement delays, filing deadline risks, and payer processing issues. Denial Resolution, Appeals & Account Follow-Up • Research, correct, and resolve Medicare Return to Provider (RTP) rejections and other governmental payer claim rejections • Review and resolve daily claim response reports, rejection reports, and billing exception reports • Analyze denial root causes and implement corrective actions to prevent recurring issues • Prepare, submit, and follow up on appeals, reconsiderations, and payer dispute requests within filing deadlines • Perform timely follow-up on assigned governmental accounts, aged trial balance accounts, work queues, and denial reports • Continue account follow-up until final resolution is achieved.