Full employer posting
We are seeking an experienced Billing Claims Analyst with extensive knowledge of UB-04 billing and Medicare regulations. This role is responsible for accurate claim submission, follow-up, and resolution of Medicare hospital billing issues to ensure timely reimbursement and compliance with CMS guidelines. Pre-Employment
We are a drug free facility. Passing a pre-employment drug screening is required . Education Requirements Must have a High School Diploma or GED.
Coding certificate preferred. Job
5 - 10 years of hospital experience in 1500 and UB04 Billing, preferably Medicare. Recent working knowledge in Medicare Direct Data Entry (DDE) System. Proficiency navigating the WPS Medicare website, including ADRs, medical record uploads, appeals, and claim review In-depth knowledge of CMS Local Coverage Determinations (LCDs) related to hospital tests and procedures Experience calculating Medicare days (co-days, lifetime reserve days) Experience with Medicare edits, 72-hour overlap claims, clinical trials, and Hospice billing Ability to analyze, resolve, and appeal claim rejections and denials from Medicare, other payers, and clearinghouse
About the role
This role is responsible for accurate claim submission, follow-up, and resolution of Medicare hospital billing issues to ensure timely reimbursement and compliance with CMS guidelines.