Medicare Billing & Follow-up Specialist - 252098

Schedule: 7:00 AM – 3:30 PM (flexible)

About the Role

We are hiring an experienced Medicare Billing & Follow-Up Specialist to support a high-performing revenue cycle team. This role is ideal for someone who can work independently, manage volume, and confidently resolve complex Medicare claims.

Key Responsibilities

Billing

• Submit and manage Medicare claims in Epic Resolute HB
• Ensure claims meet CMS clean claim standards
• Resolve edits (modifiers, scrubbing, registration issues)
• Maintain goal of zero claims over 7 days old

Follow-Up

• Handle 40–45+ accounts daily
• Resolve rejections/denials in DDE/FISS (WPS portal)
• Address CWF overlaps and MSP issues
• Partner with Coding and Revenue Integrity on denial trends

Appeals & Recovery

• Manage Medicare appeals (Redetermination through ALJ)
• Ensure timely filing compliance
• Drive resolution of unpaid/underpaid claims

Requirements

• 2+ years Medicare billing or follow-up experience
• Hospital/inpatient/facility billing background
• Epic Resolute HB experience
• Active DDE username (required)
• Strong Medicare Part A and/or B knowledge

What Sets This Role Apart

• High autonomy, no micromanagement
• Clear productivity expectations
• Fast-paced, results-driven environment
• Direct impact on reimbursement outcomes

Apply

If you’re a strong Medicare specialist who can hit the ground running and manage high volume, we’d like to connect.