Medicare Billing Specialist III - Full-Time 1st Shift

Trust, engagement, competence, respect and passion – these are the values under which North Shore Healthcare operates every day. Our dedicated team of professionals strive to deliver quality care to our residents and their families. We are one of the leading employers and providers of post-acute care in the Midwest and we are seeking exceptional individuals to join our team. If you value being a leader, working in a progressive environment and having opportunities to grow in your career, North Shore Healthcare is the Right Choice for you. Summary of position: Perform all duties related to the timely and accurate billing and collection of Medicare receivables as assigned. Essential Job Functions: Reviews, prepares, and submits Medicare as assigned. In charge of any A/R adjustments and corrections needed. Monitors and corrects all unbilled edit errors Monitors unassigned Medicare days; communicates closely with the center and takes corrective action as needed. Follow-up on all assigned outstanding accounts until balances are resolved. Utilizes company approved system for documentation and follow-up on all assigned claims. Gathers and submits Medicare Secondary Payer (MSP) claims and documentation. Manages receivables assigned by identifying issues and taking appropriate action to resolve. Corresponds with payer as needed to provide required documentation. Identifies and researches credit balances per policy and payer requirements. Identifies facility adverse trends causing non-payment or late payment of claims Contacts facility and provides appropriate training to resolve issue. Escalates issue to CBO Director if problem persists, or if necessary to address a probable global issue. Participates in AR reviews. Work with partner company to provide information for completion of Credit Balance Report. Assists with training and orientation of Medicare Billing Specialist I/II Other duties as assigned. Qualifications: High school diploma (or GED), or Minimum of five (5) year experience in health care Medicare billing, preferably long-term care. Comprehensive knowledge of the Medicare program and Prospective Payment System (PPS), including coverage and entitlement criteria, billing rules, beneficiary rights and provider responsibilities. Exposure to automated billing. Ability to manage, analyze, and reconcile billing and payment detail. Strong organizational and communication skills. Basic understanding of Excel and Word. Exposure to PCC system preferred. Exposure to Zirmed and Ability Ease All Payer software preferred. Benefits: We offer a comprehensive benefit packages which includes: Health insurance for full-time employees starting the first of the month following 30 days of employment Dental and vision insurance for full and part-time staff 401(K) Program for full and part-time staff 6 paid holidays plus one floating holiday for full-time staff Company paid life insurance for full-time staff Voluntary life and disability insurance for full-time staff Paid Time Off Our mission is to establish a culture that reinforces the values necessary to be the premier health services provider and employer in each of the communities we serve. We understand that choosing where you want to go in your career is a big decision. We would like the opportunity to show you that North Shore Healthcare is the Right Choice for you.