Inpatient Medicare Collection Specialist
$49,920–$58,240 year
On-site · Devens, Massachusetts, United States or Auburn, Massachusetts, United States
Job Summary
Inpatient Medicare Collections Specialist onsite in Auburn, MA, responsible for maximizing reimbursement and timely resolution of Medicare inpatient accounts receivable. Focuses on Medicare fee-for-service claims, including high-dollar hospital stays, by managing claim edits, resolving denials, and navigating the Medicare Direct Data Entry (DDE/FISS) system to secure accurate payment. Responsibilities include monitoring DDE system for claim status, correcting errors, investigating denied/zero-pay/underpaid claims, preparing redetermination and reconsideration appeals, working aging reports, coordinating with MACs, and ensuring CMS compliance. Requires 1–3+ years hospital billing/Medicare collections experience; Inpatient Psych experience and DDE/FISS knowledge are preferred.
Required Qualifications
- 1-3+ years of hospital billing or Medicare collections experience
- Inpatient Psych experience preferred
- Experience with Medicare DDE/FISS preferred
- Knowledge of Medicare billing rules and IPPS
- Familiarity with Medicare Secondary Payer (MSP) rules
- Strong analytical and detail-oriented skills
- Proficiency in billing systems and Microsoft Office
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