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Medical Billing Specialist

4 months ago

Tomball, United States Sentido Health Full time

Sentido pays 50% of the cost for full medical insurance

We also offer a 401k match plan up to 6% through Principal (full match up to 4% and a ½ percent match for each percent over that, up to 6%).

You get 80 hours of PTO 0-2 years, 120 hours for 3-4 years, and 160 hours for 5+ years. PTO rolls over If you already have time, you need off in your first 90 days, mention upon tie of hiring and that will not be taken from your PTO balance (within those 90 days).

You're paid on the 15th and the last day of the month; we don't withhold a paycheck, so you'll be paid immediately on this schedule.

Commission pay is paid quarterly (every 90 days/3 months), usually on the 2nd paycheck of the month or that week.

**JOB DESCRIPTION**

**Summary/Objective**
- Billing Specialists are responsible for submitting clean claims via electronic or paper submission for all services provided. Essential to this position is the ability to identify correct coding, authorization requirements are met, and ensuring compliance with all payor guidelines.

**Essential Functions**
- Prepare and submit accurate claims for all services of DME and supplies.
- Verify patient demographics, insurance information, and billing codes for accuracy.
- Confirm all sales orders for various rental and purchase items of DME and supplies by verifying all items and quantities, proof of delivery, ordering doctor, and diagnosis for accuracy.
- Ensure all coverage limitations and validation rules are met prior to marking sales order complete and closed.
- Ensure all tracking and proof of delivery is properly uploaded into Brightree for all sales orders confirmed.
- Follow established billing processes and procedures.
- Stay up to date on billing regulations and reimbursement guidelines.
- Manage multiple tasks, prioritizing workload in an efficient manner.
- Special Projects as assigned.

**Preferred Education and Experience**
- Associates degree preferred.
- Brightree experience is a plus.
- 2 or more years of medical billing experience preferred.
- DME Billing experience highly preferred.

**Performance Metrics**
- All initial claims are filed within appropriate time limits set by payors.
- All initial claims filed to correct payor with all appropriate additional payors associated to the invoice.
- All pending orders followed up on every 48 hours and reported to supervisor if unable to confirm after one week of shipment with continued follow-up until able to confirm.
- All orders for the month were confirmed no later than the 5th business day of the following month.

**Supervisory Responsibility**
- No

**Work Environment**
- In Office or Remote

**Physical Demands**
- Able to lift and carry up to 10lbs

**Position Type/Expected Hours of Work**
- This is a full-time position. Days and hours of work are Monday through Friday, 8:00 a.m. to 5 p.m. or other agreed upon schedule.

**Travel**
- None

**Organizational Requirements**
- Experience recognizing the needs and concerns of individuals.
- Effectively communicate orally and in writing
- Ability to follow verbal and written instruction.
- Able to work in a fast-paced, self-directed environment.
- Detail oriented with excellent time management skills.
- Decision-making, problem resolution and creative thinking skills.
- Responds well to multitasking while providing exceptional customer service, support, and responsiveness.
- Should be honest, competitive, energetic, enthusiastic, professional, and systematic.

**Other Duties**
- Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.