Apr-Drg Billing Specialist– Medicare

Careers Inc

  • Puerto Rico
  • Permanente
  • Tiempo completo
  • Hace 7 días
J*ob Summary: *Prepare and submit Medicaid and Medicare claims using APR-DRG methodology.· Review clinical documentation to ensure accurate coding and billing compliance.· Collaborate closely with coders, clinicians, and revenue cycle staff to resolve discrepancies before claim submission.· Identify, research, and resolve claim denials, rejections, and underpayments.· Monitor accounts receivable and follow up on outstanding claims.· Ensure compliance with federal and state regulations, payer guidelines, and hospital policies.· Analyze trends in reimbursement and claim denials to propose process improvements.· Assist in audits and provide documentation support for internal and external reviews.· Maintain accurate records of billing, coding, and claim submissions.· Work with IT or billing software teams to optimize billing workflows and reporting· Prepare and submit Medicare claims using APR-DRG.*Experience / Requirements:*· Minimum of 3 years of experience in Medicaid billing.· Strong knowledge of APRs and APR-DRG.· Familiarity with HIS/EHR systems and hospital billing platforms.· Excellent analytical skills and attention to detail.· Medical billing certification (e.g., CPC, COC, CPB) preferred.Job Type: Full-timePay: $1.00 - $2.00 per dayWork Location: In person

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