**Overview** Do you have at least 3 years of medical billing/collection experience? We at MHealth Fairview are looking for you to join our amazing team at our Kasota location located in Minneapolis! This benefits eligible position is a **1.0FTE(80 hours/2 weeks)** on the **day shift.** This position will be responsible for but not limited to Medicare as a payer. This position requires great attention to detail and analytical thinking due to the complexity of Medicare/Medicaid regulations. Responsible for day to day functions of assigned accounts. Maintain and update billing activity. Ensure accurate and timely billing, collections, appeal of home infusion claims. Perform collection tasks to obtain payments. Generate and monitor aging reports. Analyze accounts for documentation, authorization, LCD, and all necessary information to determine the next step in the process. Provide superior customer service in person and on the phone to internal/external customers. Process third party and patient remittances, including posting payments, credits, and adjustments. Timely and accurate application of payments on third party and patient accounts. **Responsibilities Job Description** **Complete required Medicare training** + Understand Medicare regulations and guidelines applicable to home infusion services + Verify Medicare Criteria using Medicare Local Coverage Determination (LCD) for covered therapies + Understand ABN and CMN/DIF processes + Utilize applicable kit codes and modifiers when billing Medicare claims + Understand Medicare appeal process and utilize correct appeal forms **Provide superior customer service, in person and on the phone, to all insurance companies, Fairview entities, and patients.** + Communicate effectively, both written and verbal + Communicate appropriate information to others according to established procedures to support day-to-day operations **Process home infusion claims accurately and timely.** + Review accounts for all needed information and communicate to correct departments to add information needed to ensure proper billing. + Screen claims on-line or on paper for accuracy + Obtain appropriate information to process claims + Communicate and request necessary information from payers, patients, Fairview Department **Interpret and demonstrate accurate application of third party payer and government payer contracts.** **Understand regulatory, HMO, PPO, Federal, State and other third party payer requirements needed to prepare and or process claims** **Generate and monitor aging reports on third party payers** + Communicate denials and Eligibility of Benefits (EOB’s) to insurance company and patients + Review aging reports that have reached certain aged categories (30,60,90 days, etc.) + Maintain reports to 60 days + Generate home infusion claims for resubmission for third party payer’s outstanding balances. **Qualifications** **Minimum Education** + High School Diploma/GED **Preferred Education** + Vocational/Technical Training or Associate Degree or Certified Medical Billing **Preferred License/Certification/Registration** + Certified Pharmacy Technician **Minimum Experience** + Three to Five years medical billing or collection experience, Medicare, Medicaid, Third Party experience **Preferred Experience** + Five+ years of Medicare billing and collections experience for home infusion **EEO Statement** EEO/AA Employer/Vet/Disabled: All qualified applicants will receive consideration without regard to any lawfully protected status **Benefit Overview** Fairview offers a generous benefit package including but not limited to medical, dental, vision plans, life insurance, short-term and long-term disability insurance, PTO and Sick and Safe Time, tuition reimbursement, retirement, early access to earned wages, and more! Please follow this link for additional information: https://www.fairview.org/careers/benefits/noncontract **Compensation Disclaimer** An individual's pay rate within the posted range may be determined by various factors, including skills, knowledge, relevant education, experience, and market conditions. Additionally, our organization prioritizes pay equity and considers internal team equity when making any offer. Hiring at the maximum of the range is not typical.