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- Kankakee, IL
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AR SPECIALIST - MEDICARE I
Riverside Medical Center • Kankakee, IL
Posted 2 months ago
The Accounts Receivable Specialist Medicare I coordinates all billing and collection activitiy as related to the Medicare accounts receivable. Assists in the daily maintenance of Medicare billing guidelines and compliance. Performs other patient account duties as assigned.
- High school graduate or equivalent
- Prior Medicare billing experience preferred
- Excellent guest relation skills, including verbal and written
- PC and keyboarding skills @ 30 WPM
- Ability to work independently
- Two years hospital patient accounting experience (preferred)
- ICD10/CPT Medical Terminology Preferred
- Previous collections or insurance experience
License or Certification Requirements:
- HFMA Credentialed Revenue Cycle Representative, preferred
- Complete 10 hours of Medicare University between July 1 and May 31 each year. Submit report from Medicare University in Halogen and copy to Manager/Director for proof of completion.
Work Schedule: Days
- Ability to accurately review and bill all secondary and tertiary insurances to correct charges, bill forms and supporting documentation (EOBs).
- Appropriately identify denied claims, work to ensure that trends are identified and resolved quickly.
- Maintain daily billing queues by working claim edits or following up on claim issues.
- Maintain patient demographic information.
- Maintain the assigned Medicare, Medicare Part C, and Medicare Part B Only financial class receivables >120 days at 5% or less.
- Maintaining A/R by the use of Telephone, Internet, Worklists, Queues, ATBs and appropriate letters.
- File and re-file claims to insurance companies.
- Other duties as assigned.
- Provides accurate and timely billing of all electronic and paper claims, including but not limited to: download, edit and transmit claims.
- Responsible for timely and accurate review of the rejected claims to ensure that all claims were accepted by the payer.
- Also has the knowledge to correct any rejections to ensure claims are rebilled timely.
- Understands and applies Medicare LCD and NCD requirements-reviewing those cases that fail medical necessity and performing proper follow-up to ensure compliance with the regulations.
- Understands billing requirements for Medicare and Medicare Part C or MMAI plans billing as defined by contract, state or federal law.
Riverside Healthcare is revolutionizing care using leading-edge technology to diagnose and treat patients. We are ranked top in the nation for performance in neurosurgery, orthopedics, and heart surgery and have also been named one of the nation's 100 Top Hospitals® by Truven Health Analytics seven times. Riverside is nationally recognized for our specialty programs in obstetrics, trauma, oncology, rehabilitation, geriatrics, occupational health, psychiatric services, and treatment of alcohol and chemical dependency, as well as patient safety. We combine innovation and convenience at state-of-the-art facilities located in communities throughout the greater Kankakee area.
Riverside Medical Center proves that truly progressive medicine is being delivered in Chicago’s southwest suburbs and East Central Illinois. Join a team that is not only concerned with providing the best care possible but also with offering a work environment of advancement and growth. Riverside is a place that embraces a culture where opinions count and dedication is respected, where superior performance is rewarded with competitive salaries and excellent benefits.