Medicare Accounts Receivable Billing Representative

Total Orthopedics and Sports Medicine is seeking a dedicated Medical Billing AR Specialist with a strong background in managing accounts receivable billing and collection of payments for all designated payors, specifically Medicare, and locations in order to meet and maintain our goal to join our dynamic team. In this role, you will be responsible for transferring patient and insurance information and initiating payment processes and procedures.

The Medicare AR Billing Representative is responsible for managing and resolving outstanding Medicare claims, ensuring timely reimbursement, and maintaining compliance with payer regulations. This role requires a strong understanding of orthopedic billing, Medicare guidelines, and denial management.

The ideal candidate is well-versed in billing software, medical insurance regulations, and an expert at responding to patient and insurance inquiries. You will also be responsible for maintaining patient confidentiality, handling personal information, and accurately inputting patient data into the system. This is an in-office role.

Responsibilities:
Follow up on unpaid and underpaid Medicare claims to ensure prompt resolution and reimbursement
Analyze Explanation of Benefits (EOBs) and Remittance Advice (RAs) to identify discrepancies
Investigate and resolve claim denials, rejections, and payment variances
Submit corrected claims, appeals, and supporting documentation as needed
Work aging reports and prioritize accounts based on timely filing limits
Ensure compliance with Medicare regulations, coding guidelines, and payer policies
Codes services provided utilizing CPT and ICD-10 coding
Knowledge of Medical Terminology, ICD-10, CPT codes and the correct use of modifiers
Working rejections from the clearinghouse to correct errors for resubmissions
Generates and submits electronic claims and statements at designated intervals; corrects any errors for complete and accurate transmission of data
Able to handle patient inquiries regarding billing issues, out of network issues, and explaining insurance guidelines to patients
Read and analyze patient records to determine correct codes for billing to insurance provider
Researches and processes refund requests and overpayments
Prepares correspondence and/or collection letters
Performs other related duties as assigned by senior management
Job Type: Full-time
Pay: $25.00 - $28.00 per hour
Benefits:
401(k)
401(k) matching
Dental insurance
Health insurance
Life insurance
Paid time off
Parental leave
Vision insurance
Application Question(s):
What is your experience following up on unpaid and underpaid Medicare claims to ensure reimbursement?

Are you able to work in-office on a full-time basis? We are in Syosset, NY.

Experience:
Medicare: 1 year (Preferred)
ICD coding: 1 year (Preferred)
Medical billing: 1 year (Preferred)
Medical coding: 1 year (Preferred)
Ability to Commute:
Syosset, NY 11791 (Required)
Work Location: In person