Billing Specialist Home Medical Equipment-DME

• Job Description Job Description:
• The Billing Specialist- DME is responsible for the processing of insurance claims to Medicare and all payors within timely filing limits.
• This individual ensures all claims and invoices are tracked to the daily census to capture and maximize timely reimbursement.
• The Billing Specialist will be responsible for following up on and sending documentation as required for billing of claims to payors.
• The Specialist may be responsible for interacting with various personnel in nursing homes and rehab facilities as required.
• The specialist will build relationships internally and externally while adjusting quickly to a fast-paced environment.
• Process monthly billing of electronic claims (primary and secondary) and/or invoices for patients and facilities accurately and timely.
• Communicate updates required within the system, Ensure corrections made to billing errors and rebilling claims.
• Research, resolve and resubmit any rejected claims or billing denials in a timely manner.
• Ability to navigate multiple online EMR systems.
• Develop and maintain a working knowledge of products offered to ensure proper HCPCS coding/billing.
• Complete insurance verification to validate patient's eligibility and correct filing information.
• Maintain patient confidentiality and function within the guideline of HIPPA and Company.
• Meet daily, monthly, and quarterly billing metrics.
• Perform other related duties as assigned.
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• Experienced and Education Requirements:
• High School Diploma or equivalent (GED).
• 1-2 years work-related billing/collecting experience in a healthcare setting.
• Excellent communication skills and professionalism.
• 2-3 years of healthcare billing experience.
• General Knowledge of Medicare, Medicaid, Commercial, and Managed Medicaid requirement preferred.
• DME experience is preferred with proficiency in HCPCS and ICD-10 coding.
• Proficiency in Microsoft Office ( Word, Excel, etc) and virtual means of communication
• Performs file maintenance on patient records and information system.
• Assists insurance companies in selection of correct billing codes and equipment or service selection.
• Assists in Scheduling deliveries, pick-ups, discontinuances, maintenance or changes in service.
• Participates in Improvement of Operational Performance (IOP) activities.
• Participates in traditional and e-learning programs.
• Works effectively with other company employees, managers, and departments.
• Performs all job functions with Company Mission, Vision, and Goal Statements in mind.

Education, Certificate, and Licensure

High school diploma or general education degree (GED); three to six months industry related work experience and/or training; or equivalent combination of education and experience.

Billing Certification a PLUS

All candidates must possess a valid driver’s license, clean driving record and criminal background (candidates will undergo a motor vehicle and criminal background check as part of the hiring process). Candidates will also be subject to a drug screen to be considered for the position.

Prior Home Health Care retail experience a PLUS.

No professional certificate or licensure required, although preferred.