MEDICARE BILLING SPECIALIST

The Medicare Billing Specialist is responsible for accurately billing Medicare for medical services rendered and ensuring compliance with all CMS (Centers for Medicare & Medicaid Services) regulations. This role involves preparing, reviewing, and submitting claims, resolving denials and rejections, and maintaining up-to-date knowledge of Medicare billing guidelines for both institutional and professional claims.

Qualifications :

High school diploma or equivalent required; Associate's degree or medical billing certification preferred (e.g., CPB , CBCS , or CPC ).

2+ years of experience in Medicare billing (Part A and / or Part B).

Strong understanding of CMS rules, claims adjudication processes, and denial management.

Familiarity with Medicare claim forms ( UB-04, CMS-1500 ) and EDI formats.

Experience using billing software (e.g., Epic, Meditech, Cerner, eClinicalWorks ) and clearinghouses (e.g., Optum, Change Healthcare ).

Proficiency in Medicare portals and tools (e.g., Noridian, Novitas, Palmetto GBA , etc.).