Medicare Specialist

Summary

Parallon provides revenue cycle management and patient account resolution services for HCA Healthcare and external clients. The Medicare Specialist manages Medicare receivable processing, including claim review, billing, collections, account maintenance, reconciliation, productivity tracking, and resolution of outstanding claim edits.

Responsibilities

• Maintains current knowledge of all office operations, job specific requirements and related regulations
• Reviews all claims for completeness, reasonableness of charges, and appropriateness of billing codes, and payer information
• Pursues timely collection of each claim using thorough follow-up efforts appropriate to each payer
• Contacts and effectively communicates with all parties involved in the resolution of accounts placed
• Completes work request timely and in accordance with instruction
• Performs all tasks necessary to maintain current and accurate account information in each of the appropriate systems (i.e. entering notes, claims on hold)
• Maintains department daily productivity goals in completing a set number of accounts while also meeting quality standards as determined by leadership
• Provides support for team members that may be absent or backlogged
• Analyzes, investigates, and resolves outstanding edits in order to submit clean claims to Medicare
• Performs appropriate non-billable adjustments and plines as necessary
• Brings problems and troubling accounts, as well as related questions, to his/her immediate supervisor’s attention daily

Skills

• 1 year in a productivity/quality-based role or direct office experience preferred

Qualifications

Nice to Haves

• 1 year in a productivity/quality-based role or direct office experience preferred

Benefits

• Work from Home position
• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
• Wellbeing support, including free counseling and referral services
• Paid time off
• Paid family leave
• Long- and short-term disability coverage
• Leaves of absence
• 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
• Employee Stock Purchase Plan
• Flexible spending accounts
• Preferred banking partnerships
• Retirement readiness tools
• Rollover support
• Financial wellbeing counseling
• Tuition assistance
• Student loan assistance
• Certification support
• Dependent scholarships
• Partnership with Galen College of Nursing
• Fertility and family-building benefits
• Adoption assistance
• Life insurance
• Supplemental health protection plans
• Auto and home insurance
• Legal counseling
• Identity theft protection
• Consumer discounts