Medicare AR 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.

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?

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