Billing Specialist, DME
1 month ago
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 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. An ideal candidate has prior experience using Bright Tree software and payor portals. The Specialist may be responsible for interacting with various personnel in nursing home and rehab facility as required. The specialist will build relationship internally and externally while adjusting quickly to a fast-paced environment.
Responsibility includes the following:
- Process monthly billing of electronic claims (primary and secondary) and/or invoices for patients and facility accurately and timely.
- Communicate updates required within the system, are made to correct 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 and use Bright Tree software.
- Contact facility on the status of Medicaid pending residents.
- 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.
- Ability to multi-task in a rapidly growing and changing environment.
- Perform other related duties as assigned.
Experience and Education Requirements:
- High School Diploma or equivalent. (GED)
- Excellent communication skills and professionalism.
Preferred Qualification:
- 2-3 years of healthcare billing experience.
- Billing Certification preferred
- General Knowledge of Medicare, Medicaid, Commercial and Managed Medicaid requirement preferred.
- DME experience preferred with proficiency in HCPCS and ICD-10 coding.
- Experience with Bright Tree software and payer portals.
- Proficiency in Microsoft Office ( Word, Excel, etc.) and virtual means of communication.
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