Medicare Billing & Follow-up Specialist

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 4045+ 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 youre a strong Medicare specialist who can hit the ground running and manage high volume, wed like to connect.