Responsibilities: • Prepare and submit clean claims for Durable Medical Equipment to various insurance carriers, including Medicare, Medicaid, and commercial payers. • Ensure all billing is accurate and adheres to payer policies and procedures, reviewing documentation to verify coverage and proper coding. • Collaborate with the insurance verification team to confirm patient eligibility and benefit coverage prior to claim submission. • Work closely with team members, patients and Insurance plans to ensure accurate billing information. • Maintain up-to-date knowledge of billing regulations, including Medicare and Medicaid guidelines, HIPAA compliance, and payer-specific policies. • Conduct timely follow-up on unpaid or underpaid claims, re-submit denials, and resolve claim discrepancies. • Investigate and appeal denied claims, working with payers to resolve issues and ensure accurate reimbursement. • Maintain accurate and detailed records of all billing activities, payments, denials, and correspondence with payers • Perform other duties related to RCM as assigned by the department supervisor.
Qualifications: • High school diploma or equivalent. • Minimum of 1-3 years of experience in healthcare billing: Medicare DME billing preferred. • Experience with billing software systems (Brightree experience preferred) • Proficiency in medical billing software and electronic health records. • Excellent organizational and multitasking skills. • Effective communication skills, both written and verbal. • Ability to work independently and as part of a team in a dynamic environment.
Benefits: • Competitive salary and comprehensive benefits package. • Opportunities for professional development and career advancement. • Supportive team environment.