Job Description

Inc.Position: Sr. Revenue Cycle Specialist: Medicare Collections

Location:Irvine, CA

Duration: Long Term

Seeking a candidate in or near Irvine, CA, Federal Way, WA, or Denver, CO. Remote positions will also be considered.

About Us:

At Tranzeal Inc, we're in search of a Senior Revenue Cycle Specialist who excels in Medicare Collections to join our dynamic Revenue Operations Department. We're looking for individuals who are highly ambitious, results-driven, and possess a knack for root cause analysis. If you're detail-oriented, thrive in a fast-paced team environment, and have strong mathematical and analytical skills, we want to hear from you. Our ideal candidate is energized by the pursuit of metrics-driven success and excels at multitasking.

Key Responsibilities:

As a Senior Revenue Cycle Specialist, you will play a crucial role in contacting Medicare Administrative Contractors (MACs) to reconcile outstanding accounts receivable (debit balances), research and resolve problem accounts, and request adjustments or rebills on claims. Your core responsibilities will include:

Research and Resolution: Initiate follow-up and resolve all unpaid or underpaid system debit balances on Medicare insurance claims. This includes tasks such as remit review, calling payer(s) and clinics, rebilling, navigating payer portals, and taking adjustments.
Root Cause Analysis: Utilize critical thinking, problem-solving, and analytical skills to determine the root cause of underpayments and follow the appropriate policies and procedures to remediate issues.
Systems Navigation: Navigate through various payer systems and internal tools to ensure timely and accurate resolution of Medicare claims.
Documentation: Leverage exceptional organization, written, and verbal communication skills to produce detailed documentation of research and actions taken on claims.
Reporting: Provide ad hoc monthly reporting on outstanding debit balances and trends.
Stay Current: Keep abreast of communications related to healthcare reimbursement and regulatory changes.
Relationship Building: Develop and maintain positive working relationships with clinical personnel, teammates, and payer representatives.
Deadline Adherence: Work well under pressure in a fast-paced environment, meeting deadlines and carrying out assignments to completion while maintaining a positive attitude.
Confidentiality: Maintain confidentiality of all company and patient information in accordance with HIPAA regulations and [Your Company Name] policies.

Qualifications:

Medicare Experience: 2+ years of Medicare experience (required)
Accounting and Billing: 2+ years of experience with generic accounting, transactions, or medical billing systems (preferred)
Healthcare Expertise: Healthcare and medical billing/collections/denial remediation experience (required)
Computer Skills: Intermediate computer proficiency in Microsoft Office tools, including Excel, PowerPoint, and Outlook (preferred)

Education:

High school Diploma or equivalent (required)
Associates or Bachelor's degree (preferred)

Skills:

Required: Billing, Collections, Claims, Medicare, Problem-Solving, Accounting
Additional: Multitasking, adjustments, billing systems, Microsoft Office, medical billing, metrics, Excel, billing remediation, root cause analysis, medical invoicing, credit scores, credit tasks, HIPAA, documentation, Microsoft PowerPoint, auto insurance, operations, credit issues

Tranzeal is an equal opportunity employer and welcomes candidates from diverse backgrounds to apply. If you're a self-motivated, detail-oriented professional with a passion for Medicare Collections and a commitment to delivering results, we encourage you to apply and join our team.

Job Type: Contract

Pay: $25.21 - $27.00 per hour

Expected hours: 40 per week

Benefits: