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Medicare Accounts Receivable Specialist

Job ID: 4657908
Updated: June 12, 2018
Geographic Location: 
Department: Insurance Follow Up
Full/Part Time: Full-Time
Shift: Days
Standard Hours: 40
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Job Summary

This position is located onsite with Mercy Health, a client of Ensemble Health Partners. To learn more about Mercy, click the link below to apply.

Medicare Accounts Receivable Specialist:

The Medicare Accounts Receivable Specialist will perform the following duties:

Working knowledge of all facets of Medicare claim filing, requirements and regulations including but not limited to: Medicare 72 hour rule, Medicare return to provider claims (RTPs), Medicare secondary billing

Knowledge of Medicare Secondary Payer Questionnaire, Common Working File updates, ADR request completion and RAC audit review

Maintain work queue in Patient Accounting System daily to ensure timely follow up

Research account specifics to complete necessary follow up actions

Contact insurance payors via telephone on aged/delayed claims for resolution

Contact patients/insurance companies on unresolved claims

Communicates with all parties in a professional manner and provides explanations regarding the account(s)

Ensure confidentiality of all patient accounts by following HIPAA guidelines

Adheres to compliance of CMS and other payor guidelines

Responsible for being aware of the current department policies and procedures

Posts any denials received from insurance payors

Post adjustment requests and explanations timely as identified

Meet or exceed quality and quantity benchmark targets as established by management (productivity, AR days, Cash Collections, Bad Debt, Past Due Follow Up)

Communicate daily with management on payor trends identified

Maintain complete and accurate follow up actions in Patient Accounting Systems

Attend in-services, education sessions and department meetings as scheduled

Performs other duties as assigned

Qualifications - Minimum

Required education, skills and experience:

High school diploma or equivalent

Requires working knowledge of Medicare billing and collections

Requires Experience working with Medicare DDE/FISS

Working knowledge of medical terminology and insurance claim filing experience

Detail oriented, analytical and ability to problem solve

Excellent written and oral communication skills

Working knowledge of Microsoft Word and Excel or equivalent

Shift and Job Schedule

40 Hours/week.

Day Shift.

Equal Employment Opportunity

It is our policy to  abide by all Federal and State laws, as well as, the requirements of 41 CFR 60-1.4(a), 60-300.5(a) and 60-741.5(a), prohibiting discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibiting discrimination against all individuals based on their race, color, religion, sex, sexual orientation, gender identity, or national origin.


About Us

This position will be a part of the revenue cycle team at Ensemble Health Partners - a wholly owned subsidiary of Mercy Health. Ensemble Health Partners specializes in providing revenue cycle solutions and creating real value for its clients by building relationships, reducing revenue cycle spend and delivering exceptional results. Ensemble partners with hospitals across the United States to make real and lasting improvements that impact the bottom line.


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