Medicare and Medicaid Billing Specialist

KEY RESPONSIBILITIES:

• Completes timely claim submission, denial management, payment variance, and accounts receivable resolution.
• Imports, edits, corrects and transmits hospital claims on a daily basis.
• Ensures activity is fully documented related to claim submission, follow-up and resolution in hospital systems.
• Investigates and/or refers to management systemic billing issues that cause delays in reimbursement.
• Identifies administrative denials by working denial work-items and through remittances; follows through with appeal or corrective action to obtain claim payment.
• Applies payor acceptance reports and 277 reports to manage payor rejections and take appropriate action for resolution.
• Applies appropriate HOLDS and subsequently releases claims based on billing requirements, coding needs and data deficiency.

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Maryland Workforce Exchange - Maryland.gov

https://mwejobs.maryland.gov