Medicare Specialist/Revenue Cycle

Seeking a detail-oriented Medicare AR Specialist to drive revenue cycle excellence. In this role, you won't just "check boxes"—you will be the primary troubleshooter for a Medicare portfolio. You will manage the full lifecycle of Medicare claims, from initial follow-up to complex appeals, ensuring our multi-state revenue stream remains healthy and efficient.

The ideal candidate is a MAC portal expert who understands the nuances of billing and has the persistence to hunt down every dollar owed.

salary: $19 - $22 per hour
shift: First
work hours: 8 AM - 5 PM
education: High School

Responsibilities

• Active Claim Recovery : Resolve unpaid, denied, or pending Medicare claims by navigating various MAC portals (Novitas, First Coast, Palmetto, Noridian, WPS, NGS, etc.).
• Denial Management : Research, resolve, and trend claim rejections. You’ll prepare and submit high-quality appeals and reconsiderations when the payer gets it wrong.
• Technical Billing : Review and correct HCFA 1500 (CMS-1500) professional claims, with a specific focus on telemedicine and tele-neurology accuracy (place-of-service, modifiers, etc.).
• Multi-State Compliance : Manage claims across various state lines, ensuring strict adherence to payer-specific regulations and Medicare guidelines.
• Payment Validation : Audit EOBs/ERAs to ensure accurate posting and identify payment discrepancies before they become long-term issues.
• Strategic Reporting : Identify recurring denial trends and collaborate with the coding and compliance teams to prevent "leakage" at the source.
• AR Cleanup : Support special projects and aging-reduction initiatives to keep our accounts receivable lean and current.

Qualifications

• 2+ years of dedicated Medicare AR follow-up or payer collections.
• Expert-level knowledge of Medicare claim processing and navigating MAC portals.
• Proficient with HCFA 1500 / CMS-1500 forms and interpreting complex EOBs/ERAs.
• Practical experience with telehealth/telemedicine billing workflows and compliance a plus.
• A track record of meeting high-volume productivity goals without sacrificing accuracy.

Skills

• Denials and Appeals (2 years of experience is required)
• MAC portals (1 year of experience is required)
• Multi-State Medicare Claims (2 years of experience is required)
• Medicare AR follow up (2 years of experience is required)
• HCFA1500 and CMS 1500 forms (1 year of experience is required)

Qualifications

• Years of experience: 2 years
• Experience level: Experienced

Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.

Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact [email protected].

Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).

This posting is open for thirty (30) days.