UofL Health, Inc.
Medicare Specialist, 250 E Liberty page is loaded## Medicare Specialist, 250 E Libertylocations:
Louisville, Kentucky:
Remotetime type:
Full timeposted on:
Posted Todayjob requisition id:
JR 2025-104931# **Primary Location:**Med Plaza II - UMC# **Address:**250 E LibertyLouisville, KY 40202# **Shift:**First Shift (United States of America)# **Job Description Summary:**# **Job Description:**This position requires thorough knowledge of the Uniform Bill, Medicare and Medicare Advantage billing, secondary deductible/coinsurance billing, and the Direct Data Entry (DDE) system for follow up. The specialist performs all duties related to timely and efficient billing and follow-up using their thorough understanding of Medicare eligibility, benefits, determining primary payer, and covered benefits.# **Additional Job Description:*** Monitor and resolve claims holding on discharged not final billed (DNFB) list.* Assure all claims are filed electronically except for some paper claims.* Identify payers being submitted on paper rather than electronically and communicate the opportunities to leadership.* Follow up on unpaid Medicare and Medicare Advantage claims in a timely manner.* High dollar accounts will have consistent follow up until the account has been resolved.* Responsible for reviewing and understanding explanation of benefits/remittance advice.* Assure statements are generated for the patient responsibility amounts.* Utilize insurance websites to view and resolve claims.* Perform extensive account follow-up and provide analysis of problem accounts.* Document all follow up efforts in a clear and concise manner into the AR system.* Submit shadow claims to Medicare for inpatient Medicare Advantage payers.* Familiar with inpatient only procedure list and work with Revenue Cycle leadership to prevent denials* Audit, research accounts, payment posting, contractuals to confirm the accuracy of the balance of the account* Adhere to Medicare Secondary Payer Questionnaire guidelines for coordination of payment/coverage with all other appropriate payers.* Assure medical record requests are documented and submitted in a timely manner* Submit RAC correspondence to appropriate Denials/Appeals Specialist.* Identify and report all trends that may provide insight into payment challenges.* Phone contact with patient, physician office, attorney, etc for additional information to process claims.* Work assigned accounts as directed while reaching daily productivity goals.* Complete tasks by deadline.* Attend seminars as requested.* Other duties as assigned. #J-18808-Ljbffr
Louisville, Kentucky:
Remotetime type:
Full timeposted on:
Posted Todayjob requisition id:
JR 2025-104931# **Primary Location:**Med Plaza II - UMC# **Address:**250 E LibertyLouisville, KY 40202# **Shift:**First Shift (United States of America)# **Job Description Summary:**# **Job Description:**This position requires thorough knowledge of the Uniform Bill, Medicare and Medicare Advantage billing, secondary deductible/coinsurance billing, and the Direct Data Entry (DDE) system for follow up. The specialist performs all duties related to timely and efficient billing and follow-up using their thorough understanding of Medicare eligibility, benefits, determining primary payer, and covered benefits.# **Additional Job Description:*** Monitor and resolve claims holding on discharged not final billed (DNFB) list.* Assure all claims are filed electronically except for some paper claims.* Identify payers being submitted on paper rather than electronically and communicate the opportunities to leadership.* Follow up on unpaid Medicare and Medicare Advantage claims in a timely manner.* High dollar accounts will have consistent follow up until the account has been resolved.* Responsible for reviewing and understanding explanation of benefits/remittance advice.* Assure statements are generated for the patient responsibility amounts.* Utilize insurance websites to view and resolve claims.* Perform extensive account follow-up and provide analysis of problem accounts.* Document all follow up efforts in a clear and concise manner into the AR system.* Submit shadow claims to Medicare for inpatient Medicare Advantage payers.* Familiar with inpatient only procedure list and work with Revenue Cycle leadership to prevent denials* Audit, research accounts, payment posting, contractuals to confirm the accuracy of the balance of the account* Adhere to Medicare Secondary Payer Questionnaire guidelines for coordination of payment/coverage with all other appropriate payers.* Assure medical record requests are documented and submitted in a timely manner* Submit RAC correspondence to appropriate Denials/Appeals Specialist.* Identify and report all trends that may provide insight into payment challenges.* Phone contact with patient, physician office, attorney, etc for additional information to process claims.* Work assigned accounts as directed while reaching daily productivity goals.* Complete tasks by deadline.* Attend seminars as requested.* Other duties as assigned. #J-18808-Ljbffr