Job Description
Responsibilities Prepare and submit clean claims for Durable Medical Equipment to various insurance carriers, including Medicare, Medicaid, and commercial payers. 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. Support billing team members, providing training, coaching, and feedback. Monitor daily billing workflows to ensure timely submission of claims for all payers. Review and resolve complex billing issues or escalated claims, including denials and rejections. Collaborate with Intake, Prior Authorization, and Insurance Verification teams to ensure complete and accurate billing documentation. Qualifications High school diploma or equivalent. Minimum of 1-3 years of experience in healthcare billing: Medicare DME billing preferred. Strong understanding of HCPCS codes, modifiers, LCD guidelines, and Medicare/Medicaid/commercial payer rules. 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. recblid oxwr3pc1dvoyi2a9mywxe2798ckr6f