Revenue Cycle Medical Billing Appeal Medicare Follow-Up Specialist

Revenue Cycle Medical Billing - Appeal - Medicare Follow-Up Specialist

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

Hourly Compensation: $18

(this position is bonus eligible)

Work Schedule: Full-Time

Job Summary

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.

Essential Functions/ Duties

• 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.

Qualifications

Required Experience:

• 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

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

Why Choose AMR? AMR is one of Global Medical Response's (GMR) family of solutions. Our GMR teams deliver compassionate, quality medical care, primarily in the areas of emergency and patient relocation services. View the stories on how our employees provide care to the world at www.AtaMomentsNotice.com.

GMR's Core Behaviors-keep care at the center, raise your hand, seek to understand, find a way together and be accountable-unite our teams and set us apart in emergency medical services.

Global Medical Response and its family of companies are an Equal Opportunity Employer, which includes supporting veterans and providing reasonable accommodations for individuals with a disability.

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