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Medicare Jobs in USA

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Medicare • usa

Last updated: 5 days ago

Medicare Billing Specialist

united surgical partners internationalDallas, TX, US
Full-time

We are looking for a motivated performer to join the Centralized Training Office as a Hospital Billing Specialist focused on Medicare.We are looking for a top performer with extensive knowledge of ... Show more

Fraud Investigator - Medicare

peratonWatkinsville, GA, United States
$66,000.00–$106,000.00 yearly
Full-time

SafeGuard Services (SGS), a subsidiary of Peraton, performs data analysis, investigation, and medical review to detect, prevent, deter, reduce, and make referrals to recover fraud, waste, and abuse... Show more

Medicare Insurance Agent

core value insurance groupFeasterville-Trevose, PA, USA
$100,000.00 yearly
Full-time
Quick Apply

Join Core Value Insurance Group (CVIG)Core Value Insurance Group is a rapidly scaling, family-owned, employee-focused Medicare brokerage serving tens of thousands of clients nationwide.We are looki... Show more

Medicare Retention Specialist

solis health plansMiami, FL, United States
Full-time

The Medicare Retention Specialist is responsible for supporting member retention efforts by providing exceptional customer service to Medicare Advantage members.This role focuses on addressing memb... Show more

Medicare Insurance Agent — Final Expense & Medicare Products

team nexa insurance solutionsHouston, TX, US
Full-time +1
Quick Apply

YOUR MEDICARE CAREER STARTS HERE AND YOU WON'T WALK IN ALONE.Join a team that gives you the products, training, and support to build a thriving Medicare business — from day one.Medicare Suppl... Show more

Medicare Benefits Advisor

pyramidPortland, OR, United States
Full-time +1

Immediate need for a talented Medicare Benefits Advisor.This is a 03-04 months contract opportunity with long-term potential and is located in Oregon (Hybrid).Key Responsibilities include supportin... Show more

Director of Medicare

pacific sourceSalem, OR, United States
Full-time

Looking for a way to make an impact and help people? Join PacificSource and help our members access quality, affordable care! PacificSource is an equal opportunity employer.All qualified applicants... Show more

Medicare Operations Analyst

partnership health plan californiaFairfield, CA, United States
Full-time

The Medicare Operations Analyst is responsible for ensuring operational excellence across delegated entities during implementation and post Go-Live implementation for Medicare DSNP program.In colla... Show more

SVP, Medicare

kaiser permanenteOakland, CA, United States
Full-time

The SVP, Medicare reports to the SVP, Government Programs.He/she is responsible for ~$30B in revenue for the Medicare Line of Business (LOB).Specific duties include overall margin and quality perfo... Show more

Medicare Plan Coordinator

mount sinai medical centerHialeah, FL, United States
Full-time

Serves as the point person for all Medicare Part D related activities at Eldercare.Supports the annual Part D bid by keeping timely and accurate records of all pharmacy related expenses, bid tracki... Show more

Medicare Enrollment Trainee

health plan assistantsRemote, US
$112,000.00–$225,000.00 yearly
Remote
Full-time

Medicare Insurance Agent - Remote, Training & Licensing Support.Looking for a flexible career where you can help people while building long-term income?.We’re looking for motivated individuals inte... Show more

Medicare Advantage Manager

zs associatesPrinceton, NJ, United States
Full-time

Health Plan Manager for Medicare Advantage Center of Excellence.ZS is a place where passion changes lives.As a management consulting and technology firm focused on improving life and how we live it... Show more

Medicare Pricing Analyst

wps health solutionsMadison, WI, United States
Full-time

The Medicare Pricing Analyst is responsible for researching complex Medicare pricing and reimbursement issues while ensuring the accuracy and effectiveness of Medicare claims processing and coding ... Show more

Medicare Specialist / Medicare Benefit Advisor

farmers insurance the hadder agencyHOOVER, AL, US
$50,487.00–$60,568.00 yearly
Full-time
Quick Apply

Medicare Specialist / Medicare Benefit Advisor.Help People Navigate Medicare With Confidence.Every day, thousands of Americans become eligible for Medicare and face important decisions about their ... Show more

Medicare Sales Specialist

century benefitsVancouver, Washington, US
Full-time

Century Benefits | Full-Time | In-Office | Base + Commission | 72,000–180,000 Potential.Build Your Career in Medicare Sales.Are you a motivated insurance professional who enjoys helping people make... Show more

RN-MEDICARE

forrest general hospitalPrentiss, Mississippi, United States, 39474
Full-time

The Medicare registered nurse (RN) performs under the direct supervision of the Director of Nursing and is delegated an assignment by the Director of Nursing to achieve quality care for all Medicar... Show more

Medicare Sales Representative

keystone advisorsHouston, Texas, United States
Full-time +1

Group 1 Life and Health Insurance License Required***.Keystone is a fast-growing company seeking top talent employees.If you want to be part of a team with a purpose Keystone may be right for you.W... Show more

Medicare Sales Agent

pitch health solutionsAZ, US
$20.00 hourly
Full-time
Quick Apply

Medicare Advantage Sales Agent (Remote) Pitch Health Solutions Pitch Health Solutions is a rapidly growing national agency specializing in Medicare Advantage, Hospital Indemnity, Final Expense, and... Show more

Medicare Domain SME

conflux systemsJefferson City, MO, United States
Full-time

Location: Jefferson City MO, USA - Remote.Capitation Revenue reconciliation.This Expert must be able to play a leadership role in managing and coordinating the members of the BIA team.They must hav... Show more

Medicare Billing Specialist

healthcare nursing centerCharleston, IL
Full-time

Charleston, Illinois (on-site).The Medicare Billing Specialist is responsible for ensuring accurate and timely billing of all Medicare claims within a skilled nursing environment.This role requires... Show more

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Medicare Billing Specialist

Medicare Billing Specialist

united surgical partners internationalDallas, TX, US
30+ days ago
Job type
  • Full-time
Job description

Position Overview:

We are looking for a motivated performer to join the Centralized Training Office as a Hospital Billing Specialist focused on Medicare. We are looking for a top performer with extensive knowledge of billing processes. Reporting to the Billing Manager, the Hospital Billing Specialist, Medicare is responsible for the timely and accurate submission of claims ensuring those claims result in maximum reimbursement. This will encompass services rendered in an Acute Care Surgical Hospital setting.

Responsibilities:

  • Pull any preoperative notes from the designated transcription company.
  • Extract information from medical records, operative notes, invoices, progress notes and discharge paperwork to ensure completeness and accuracy of charge entry.
  • Capture implants, high-cost supplies, high-cost drugs, post op pain blocks and observations times prior to charge submission
  • Review accuracy of invoice details, including customer billing instructions, pricing, discounts, state sales tax, etc.
  • Execute the recurring billing workflow and generate and transmit claims daily.
  • Ensure timely follow-up and resolution of internal and external inquiries of billing issues (i.e., operative notes, POPM form, invoices, or implant pricing etc).
  • Reconcile revenue and billing during the period-end close process.
  • Complete accurate charge entry for all assigned cases and upload to designated electronic claims clearinghouse daily.
  • Resolve claim rejections daily to ensure clean claims are transmitted and received by the appropriate payer.
  • Investigate, appeal, and resolve denied or unpaid claims, ensuring correct resubmission and payment.
  • Navigate the DDE and make the appropriate claims corrections when appropriate.
  • Manage claim resubmission queues in a timely manner.
  • Maintain current knowledge of health care billing laws, rules, regulations, and developments.
  • Complete Special Projects when appropriate.
  • Complete other duties as assigned.



Required Skills

  • Experience in DDE system, Ability Ease, and Novitasphere
  • 3-4 years previous Hospital billing experience, with emphasis on Medicare billing
  • Preference shown to previous experience in a Facility setting
  • Ability to work independently
  • Excellent communication skills and interpersonal skills
  • Skilled in time management and prioritization of emergent situations
  • Comfortable utilizing critical thinking skills
  • Proficient with Microsoft Office products
  • Experience with electronic patient information systems
  • Function as a subject matter expert (SME) for Medicare
  • Experience with Ability, DDE, nThrive, Cerner, etc required.



Required Experience

  • Experience in DDE system, Ability Ease, and Novitasphere
  • 3-4 years previous Hospital billing experience, with emphasis on Medicare billing
  • Preference shown to previous experience in a Facility setting
  • Ability to work independently
  • Excellent communication skills and interpersonal skills
  • Skilled in time management and prioritization of emergent situations
  • Comfortable utilizing critical thinking skills
  • Proficient with Microsoft Office products
  • Experience with electronic patient information systems
  • Function as a subject matter expert (SME) for Medicare
  • Experience with Ability, DDE, nThrive, Cerner, etc required.