Medicare Billing Specialist

Medicare Billing and Follow-Up Representative Employment Type: Contract to Hire Position Summary: We are seeking a detail-oriented and experienced Medicare Billing and Follow-Up Representative to join our Revenue Cycle team. This role is responsible for the compliant, accurate, and timely billing and follow-up of Medicare and Medicare Advantage patient accounts. The ideal candidate will have strong analytical skills, a deep understanding of Medicare regulations, and the ability to work independently in a fast-paced environment. Key Responsibilities: Work daily from EPIC work queues and Aged Trial Balance (ATB) reports to prioritize aged and high-dollar accounts. Sort and analyze claims by age, starting with the oldest, and determine payment status or denial reasons. Investigate and resolve claim denials, including requesting and uploading medical records to provider portals. Contact insurance companies and patients to resolve coordination of benefits and other claim issues. Identify denial trends and collaborate with internal teams to implement corrective actions. Submit Medicare and Medicare Advantage claims (UB-04 and 1500), including shadow bills. Ensure clean claim submission and accurate documentation for complex billing scenarios. Follow up on unpaid claims and generate correspondence as needed. Maintain and update Excel spreadsheets with ATB feedback and other pertinent data. Meet productivity metrics of 50+ accounts per day, adjusted based on account complexity and dollar value. Required Qualifications: High School Diploma or equivalent (required). Minimum 2 years of Medicare billing and follow-up experience. Strong knowledge of Medicare Part A and Part B billing processes. Proficiency in EPIC, payer portals, OnBase (scanning system), and Microsoft Excel. Familiarity with ICD-10, CPT-4, HCPC codes, and Medicare Claims Processing Manual (CMS Pub 100-4). Why Join Us? Collaborative and supportive team environment. Opportunity to make a meaningful impact on patient financial outcomes. Professional development and growth opportunities.