Inpatient Medicare Collection Specialist

Join Us as Inpatient Medicare Collections Specialist!

Full Time 40 hours onsite in Auburn MA

The Inpatient Medicare Collections Specialist is responsible for maximizing reimbursement and ensuring timely resolution of Medicare inpatient accounts receivable. This role 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 and timely payment.

Inpatient Medicare Collections Specialist Job Responsibilities:

• Monitor Medicare DDE (FISS) system for claim status updates including edits RTP and suspended claims.
• Correct claim errors billing discrepancies and coding-related issues.
• Investigate and resolve denied zero-pay or underpaid Medicare claims.
• Prepare and submit redetermination and reconsideration appeals.
• Work Medicare aging reports daily and prioritize high-dollar accounts.
• Communicate with Medicare Administrative Contractors (MACs) to resolve claim issues.
• Coordinate patient responsibility and secondary billing.
• Ensure compliance with CMS regulations and proper documentation.
• Other Collections activity as assigned

Inpatient Medicare Collections Specialist will have the following:

• 13 years of hospital billing or Medicare collections experience.
• Inpatient Psych experience preferred.
• Experience with Medicare DDE/FISS 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

When you join the growing TaraVista team youre not just taking a job youre making a difference in peoples lives. As our team member youll receive:

• Medical Dental and Vision
• 401(k) match
• Employer paid short term disability (STD)
• Employer paid life and AD&D Insurance
• Generous Paid Time Off
• Flexible Spending Account
• Tuition Reimbursement

Pay Range

Compensation will be determined based on the candidates relevant experience.

$24.00 - $30.00

TaraVista is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race color religion age sex national origin disability status genetics protected veteran status sexual orientation gender identity or expression or any other characteristic protected by federal state or local laws.

Required Experience:

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