Medicare Specialist

Memorial Health System

Job Description

Basic Functions:

This position embodies the Memorial Health System Performance Excellence Standards of Safety, Courtesy, Quality, and Efficiency that support our mission, vision and values. These standards are evident in the daily work, which includes analyzing, investigating, and resolving claims/billing information and/or errors associated with inpatient and outpatient medical insurance claims, ensures compliance with managed care guidelines and MMC organizational policies.

Requirements for this position include:
Education equivalent to graduation from high school or GED is required.
One or more years of general office experience is required. Previous experience with insurance billing and software (SMS and NEBO) is highly preferred.
Basic working knowledge of personal computers and their associate user software is required. Experience with Microsoft Office products Word and Excel is preferred.
Ability to work within the guidelines of defined managed care contract policy provisions and company procedures.
Demonstrated ability to work successfully with internal customers and external contacts is required.
Possesses a highly-developed detail orientation, critical thinking, and problem solving ability.
Demonstrates excellent oral and written communication, keyboarding, and basic math skills.
Familiarity with medical terminology, medical procedural (CPT) and diagnosis (ICD-9 CM) coding, and hospital billing claim form UB-92 is highly preferred.

Employment Type



7:00 a.m.- 3:30 p.m.