Oro Valley Hospital
Medicare Billing Specialist - Full Time - Days
Oro Valley
,
AZ
Full Time
Seeking a full-time onsite Medicare Billing Specialist to support our Skilled Nursing Care department at Oro Valley Hospital, located on 1551 E Tangerine Rd, Oro Valley AZ.
Days Shift: Schedule TBD
We know it's not just about finding a job. It's about finding a place where you are respected, valued, and where your work is purposeful and fulfilling. A place where your talent is recognized, professional development is encouraged and career advancement is possible.
Benefits
As a core employee with Northwest Healthcare, you will be eligible for competitive base pay, and a robust total rewards compensation package. Included in our benefits package includes some of the following: health insurance, dental, vision, 401K, PTO and more!
Job Summary
The Medicare Billing Specialist is responsible for reviewing, correcting, and processing Medicare claims to ensure billing compliance with CMS guidelines, Office of Inspector General (OIG) regulations, and organizational policies. This role supports timely and accurate charge entry, maintains Medicare bad debt records, and collaborates with departments to resolve billing issues and support revenue integrity.
Essential Functions
Days Shift: Schedule TBD
We know it's not just about finding a job. It's about finding a place where you are respected, valued, and where your work is purposeful and fulfilling. A place where your talent is recognized, professional development is encouraged and career advancement is possible.
Benefits
As a core employee with Northwest Healthcare, you will be eligible for competitive base pay, and a robust total rewards compensation package. Included in our benefits package includes some of the following: health insurance, dental, vision, 401K, PTO and more!
Job Summary
The Medicare Billing Specialist is responsible for reviewing, correcting, and processing Medicare claims to ensure billing compliance with CMS guidelines, Office of Inspector General (OIG) regulations, and organizational policies. This role supports timely and accurate charge entry, maintains Medicare bad debt records, and collaborates with departments to resolve billing issues and support revenue integrity.
Essential Functions
- Reviews, corrects, and processes valid, failed, and held Medicare claims to ensure timely and compliant billing.
- Maintains current knowledge of Medicare regulations, charge structures, and billing practices.
- Supports department leaders by resolving charge entry issues and addressing questions related to Medicare billing.
- Assists with updates and corrections to the chargemaster, including support for new service implementation.
- Prepares and maintains the Medicare bad debt log and submits timely reports to leadership.
- Refers unresolved or non-appealable claims to management for additional review or action.
- Monitors rebill activity to identify trends, recurring issues, and opportunities for process improvement.
- Ensures proper documentation is maintained for audits, appeals, and compliance reporting.
- Performs other duties as assigned.
- Complies with all policies and standards.
- Associate Degree in Accounting, Health Information Management, or related field preferred
- 1-2 years of experience in Medicare billing, medical claims processing, or hospital revenue cycle operations required
- Experience with charge entry, Medicare bad debt, and claims editing systems preferred
- Strong understanding of Medicare billing rules, coding standards, and reimbursement guidelines.
- Ability to accurately review, correct, and process healthcare claims.
- Proficient in using billing software and electronic health record (EHR) systems.
- Detail-oriented with strong organizational and analytical skills.
- Effective communication skills for supporting departments and interacting with third-party payers.