How to hire a medicare specialist

How to hire a medicare specialist, step by step

Here's a step-by-step medicare specialist hiring guide:

• Step 1: Identify your hiring needs
• Step 2: Create an ideal candidate profile
• Step 3: Make a budget
• Step 4: Write a medicare specialist job description
• Step 5: Post your job
• Step 6: Interview candidates
• Step 7: Send a job offer and onboard your new medicare specialist
• Step 8: Go through the hiring process checklist

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1. Identify your hiring needs

   Before you post your medicare specialist job, you should take the time to determine what type of worker your business needs. While certain jobs definitely require a full-time employee, it's sometimes better to find a medicare specialist for hire on a part-time basis or as a contractor.

   Determine employee vs contractor status

   Is the person you're thinking of hiring a US citizen or green card holder?

   Yes

   No

   You should also consider the ideal background you'd like them a medicare specialist to have before you start to hire. For example, what industry or field would you like them to have experience in, what level of seniority or education does the job require, and how much it'll cost to hire a medicare specialist that fits the bill.

   This list shows salaries for various types of medicare specialists.

   Type of Medicare Specialist	Description	Hourly rate
   Medicare Specialist	Medical records and health information technicians, commonly referred to as health information technicians, organize and manage health information data. They ensure its quality, accuracy, accessibility, and security in both paper and electronic systems... Show more	$13-22
   Health Information Technician	A health information technician is primarily responsible for managing and handling patient information, ensuring accuracy and confidentiality. They coordinate with various health care workers to gather patient data, laboratory results, test findings, and medical histories, encoding them in clinical databases in a timely and efficient manner... Show more	$12-21
   Medical Biller Coder	A medical biller coder is responsible for handling the billing processes and insurance within a hospital, clinic, or similar facility. They must gather patient information and records to analyze and translate them into codes according to the insurance and medical guidelines... Show more	$14-23

   Show more

2. Create an ideal candidate profile

   Common skills:

   • Customer Service
   • Patients
   • Health Insurance
   • CMS
   • CPT
   • Appeals
   • Inbound Calls
   • Medicare
   • Medicaid
   • Medical Terminology
   • ICD-9
   • Medical Billing
   • Federal Regulations
   • Insurance Carriers

   Check all skills

   Responsibilities:

   • Manage cases by aggressively directing the litigation process.
   • Submit correct claims when appropriate, assigning ICD-9-CM, CPT, HCPCS, and / or service codes when necessary.
   • Maintain HIPPA compliance with all communications.
   • Obtain accurate ICD-9 codes and process completed CMN's.
   • Include knowledge of ICD-9 codes and state fee schedules/usual and customary.
   • Code claims using the CPT and ICD-9-CM coding systems appropriate at the time.

3. Make a budget

   Including a salary range in your medicare specialist job description is a great way to entice the best and brightest candidates. A medicare specialist salary can vary based on several factors:

   • Location. For example, medicare specialists' average salary in south carolina is 30% less than in connecticut.
   • Seniority. Entry-level medicare specialists earn 37% less than senior-level medicare specialists.
   • Certifications. A medicare specialist with a few certifications under their belt will likely demand a higher salary.
   • Company. Working for a prestigious company or an exciting start-up can make a huge difference in a medicare specialist's salary.

   Average medicare specialist salary

   $36,923yearly

   $17.75 hourly rate

   ---

   Entry-level medicare specialist salary

   $29,000 yearly salary

   Updated December 19, 2025

4. Writing a medicare specialist job description

   A job description for a medicare specialist role includes a summary of the job's main responsibilities, required skills, and preferred background experience. Including a salary range can also go a long way in attracting more candidates to apply, and showing the first name of the hiring manager can also make applicants more comfortable. As an example, here's a medicare specialist job description:

   Medicare specialist job description example

   Job Functions, Duties, Responsibilities and Position Qualifications:
   
   The A/R Follow Up Specialist is responsible for the management of Medicare accounts through written or verbal direction from patients, aged trial balance reports and Medicare rejection reports for the accurate and timely filing of claims for maximum reimbursement. A/R Follow Up Specialists will have the ability to provide support to other Accounts Receivable departments, as needed. All staff must adhere to all department policies and procedures.
   
   Job Responsibilities:
   
   Essential Functions:
   
   * Customer service duties include answering telephones politely and confidently for patients and others regarding billing inquiries and resolving billing issues.
   * Act as a resource regarding Medicare compliance guidelines.
   * Accurately enter information provided by various sources to correct claims in regards to CPT and ICD-10 codes and send out results in a timely manner to Medicare.
   * Must be able to interpret and communicate Medicare Explanation of Benefits.
   * Must be able to make calls to insurance carrier to obtain elaborated description of the claim denials.
   * Must be able to interpret and communicate Explanation of Medicare Advantage Benefits.
   * Audits accounts showing Medicare denials to resolve balances.
   * Resolve invoice issues from outside laboratories for Medicare patients.
   * Communicate with Team Lead and/or A/R Supervisor as needed.
   * Strong data entry skills, with the ability to meet production guidelines as set by A/R department policy.
   * Ability to stay work focused and performs job duties efficiently and accurately.
   * Employee must comply with Sonic Healthcare USA's compliance policies and procedures.
   * Duties include but are not limited to the above mentioned responsibilities.
   * Perform other duties as assigned.
   
   Skills:
   
   * Knowledge of computer technology and terminology
   * Ability to type and demonstrate10 key proficiency
   * Perform duties in a timely and accurate manner
   * Maintain confidentiality of information
   * Ability to communicate effectively at all levels within the company, with patients and physician office staff
   * Possess effective work habits and ability to build/maintain work relationships
   * Ability to read and comprehend English
   * Ability to work under deadlines
   
   Job Qualifications:
   
   Required:
   
   * High School diploma or GED
   * Typing (min 35 wpm) and 10 Key
   
   Preferred
   
   * 2 years' experience in standard Medicare or related HMO plans
   * Experience with medical coding, private insurance, laboratory and/or medical billing
   * Customer service experience
   * Bilingual speaking skills/Spanish
   * Experience in multitasking environment
   
   Scheduled Weekly Hours:
   
   40
   
   Work Shift:
   
   1st Shift (United States of America)
   
   Company:
   
   Sonic Healthcare USA, Inc
   
   Sonic Healthcare USA is an equal opportunity employer that celebrates diversity and is committed to an inclusive workplace for all employees. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, age, national origin, disability, genetics, veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

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5. Post your job

   To find medicare specialists for your business, try out a few different recruiting strategies:

   • Consider internal talent. One of the most important talent pools for any company is its current employees.
   • Ask for referrals. Reach out to friends, family members, and your current work to ask if they know any medicare specialists they would recommend.
   • Recruit at local colleges. Attend job fairs at local colleges to recruit entry-level medicare specialists with the right educational background.
   • Social media platforms. LinkedIn, Facebook, and Twitter have more than 3.5 billion users, and they're a great place for company branding and reaching potential job candidates.

   To find medicare specialist candidates, you can consider the following options:

   • Post your job opening on Zippia or other job search websites.
   • Use niche websites that focus on engineering and technology jobs, such as healthcarejobsite, health jobs nationwide, hospitalcareers, medreps.com.
   • Post your job on free job posting websites.

6. Interview candidates

   Recruiting medicare specialists requires you to bring your A-game to the interview process. The first interview should introduce the company and the role to the candidate as much as they present their background experience and reasons for applying for the job. During later interviews, you can go into more detail about the technical details of the job and ask behavioral questions to gauge how they'd fit into your current company culture.

   You should also ask about candidates' unique skills and talents to see if they match the ideal candidate profile you developed earlier. Candidates good enough for the next step can complete the technical interview.

   The right interview questions can help you assess a candidate's hard skills, behavioral intelligence, and soft skills.

7. Send a job offer and onboard your new medicare specialist

   Once you've selected the best medicare specialist candidate for the job, it's time to write an offer letter. In addition to salary, this letter should include details about the benefits and perks you offer the candidate. Ensuring that your offer is competitive is essential, as qualified candidates may be considering other job opportunities. The candidate may wish to negotiate the terms of the offer, and you should be open to discussion. After you reach an agreement, the final step is formalizing the agreement with a contract.

   You should also follow up with applicants who don't get the job with an email letting them know that you've filled the position.

   Once that's done, you can draft an onboarding schedule for the new medicare specialist. Human Resources should complete Employee Action Forms and ensure that onboarding paperwork is completed, including I-9s, benefits enrollment, federal and state tax forms, etc. They should also ensure that new employee files are created for internal recordkeeping.

8. Go through the hiring process checklist

   • Determine employee type (full-time, part-time, contractor, etc.)
   • Submit a job requisition form to the HR department
   • Define job responsibilities and requirements
   • Establish budget and timeline
   • Determine hiring decision makers for the role
   • Write job description
   • Post job on job boards, company website, etc.
   • Promote the job internally
   • Process applications through applicant tracking system
   • Review resumes and cover letters
   • Shortlist candidates for screening
   • Hold phone/virtual interview screening with first round of candidates
   • Conduct in-person interviews with top candidates from first round
   • Score candidates based on weighted criteria (e.g., experience, education, background, cultural fit, skill set, etc.)
   • Conduct background checks on top candidates
   • Check references of top candidates
   • Consult with HR and hiring decision makers on job offer specifics
   • Extend offer to top candidate(s)
   • Receive formal job offer acceptance and signed employment contract
   • Inform other candidates that the position has been filled
   • Set and communicate onboarding schedule to new hire(s)
   • Complete new hire paperwork (i9, benefits enrollment, tax forms, etc.)

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