Medicare Billing Specialist

Medicare Billing Specialist Capital Staffing Solutions - 3.8 Costa Mesa, CA Job Details Full-time | Contract From $25.69 an hour 4 hours ago Benefits Health insurance Dental insurance Vision insurance Life insurance Qualifications Appeals Microsoft Excel Microsoft Outlook Medicare Regulatory compliance Compliance audits & assessments High school diploma or GED CMS regulatory compliance Centers for Medicare and Medicaid Services (CMS) Medical billing Data entry Medical insurance appeals management Acute care Full Job Description Medicare Billing Specialist (Government Recovery Specialist)

Location:

Costa Mesa, CA (On-Site)

Position Type:

W2 Contract, benefits after 90 days if contract is extended

Contract Duration:

06/01/2026 - 08/29/2026

Schedule:

Full-time Extension Potential:

Possible extension; not a permanent opportunity

Leave Coverage:

FMLA coverage assignment Position Overview Seeking an experienced Medicare Billing Specialist / Government Recovery Specialist to support government audit activity and documentation compliance within an acute care healthcare setting. This role serves as a key point of contact for regulatory audits and government contractor correspondence involving Medicare and Medicaid billing compliance. The ideal candidate will have strong Medicare billing experience, knowledge of CMS reimbursement methodologies, and exposure to regulatory audits and appeals processes. Required Qualifications High school diploma or equivalent Minimum 3 years of Medicare billing experience in an acute care setting Experience with healthcare regulatory audits and appeals Understanding of CMS billing, payment, and reimbursement methodologies Experience utilizing CMS systems and processes Knowledge of privacy regulations, security regulations, release of information requirements, and CMS rules/regulations Proficiency with

Microsoft Office Suite:

Word Excel Outlook PowerPoint Experience working on complex projects in a healthcare environment Preferred Qualifications 5+ years of Medicare billing experience in an acute care setting 3+ years of experience supporting regulatory audits and appeals Experience with: Recovery Audit Contractor (RAC) Medicare Administrative Contractor (MAC) Targeted Provider Education (TPE) Comprehensive Error Rate Testing (CERT) Office of Inspector General (OIG) Medicaid and Medi-Cal audits Other government regulatory audit programs

Knowledge of:

Utilization management processes Medical necessity criteria Coding practices Key Responsibilities Support government regulatory and enforcement agency audits related to billing and documentation compliance Process incoming audit correspondence and documentation requests Perform data entry and maintain audit-related records Prepare and submit audit documentation to government agencies and contractors Respond to audit-related inquiries and correspondence Assist with pre-payment and post-payment audit activities Coordinate audit response efforts for agencies including RAC, MAC, TPE, CERT, OIG, QIO, and other regulatory entities Ensure compliance with CMS guidelines and healthcare billing regulations Serve as a central point of contact for government audit activity Additional Information Essential role supporting all government audit activity Focused heavily on documentation and billing compliance Strong attention to detail and regulatory knowledge required #AJ1

Pay:

From $25.69 per hour

Benefits:

Dental insurance Health insurance Life insurance Vision insurance

Experience:

Medicare billing: 3 years (Required) Ability to

Commute:

Costa Mesa, CA 92626 (Required)

Work Location:

In person