Experienced Medical Biller/Intake Specialist

5 days ago

Detroit, Michigan, United States HEARTS ENTERAL LLC Full time

Job Title: Experienced Medical Biller/Intake Specialist - DME Experience Required

Job Description:

We are a boutique Durable Medical Equipment Company that supplies enteral nutrition formulas including medical foods for inborn errors of metabolism. Our mission is to help fight the challenges of healthcare reimbursement for people who struggle with rare diseases and conditions that require enteral nutrition and medical foods to sustain and prolong their lives.

Key Responsibilities:

  • Accurately verify insurance benefits and complete insurance verification forms through phone calls or insurance portals.
  • Answer phone calls and emails in a timely manner, assist or direct callers to the appropriate person or department.
  • Process prior authorizations and coordinate approvals to ensure seamless medical food and DME products delivery.
  • Reverify insurance for existing patients due to annual plan changes and document approvals.
  • Review and analyze medical records and patient information to ensure accurate authorizations.
  • Resolve denials by communicating with insurance companies and patients.
  • Collaborate with patients to obtain updated insurance information when coverage issues arise.
  • Run reports to identify patients with incomplete insurance information and take proactive steps to resolve coverage gaps.
  • Order processing for wholesale orders.
  • Responsible for weekly completion of new referral patient tracking report.
  • Document, track, and communicate any concerns regarding work and/or insurance verification problems to the Billing Manager and Facility Director.
  • Attend department-required meetings as scheduled.
  • Maintain active credentials to all assigned payor portals.
  • Assist with claims submission by coordinating with our current billing and coding specialist.
  • Maintain confidentiality of patient information and adhere to HIPAA regulations.
  • Contribute to team effort by accomplishing related results as needed;
  • Promote effective working relations and work effectively as part of a team to facilitate the department's ability to meet its goals and objectives;
  • Demonstrate respect and regard for the dignity of all patients, families, and fellow employees to ensure a professional, responsible, and courteous environment;
  • Perform other duties as assigned to support Hearts Enteral's Mission, Vision, and Values.

Requirements:

  • Minimum of three years of related experience in insurance verification, and medical billing.
  • STRONG ATTENTION TO DETAIL A MUST ***
  • Excellent communication skills, with the ability to work effectively with patients, insurance providers, and team members.
  • Previous experience with an Electronic Medical Record a plus, eClinical Works, Office Ally, Availity, Navinet, and all EMR-related experience preferred;
  • Customer service driven
  • Understanding of medical terminology and insurance laws/guidelines;
  • Excellent organization and time management skills along with excellent oral and written communication skills;
  • Strong team player;
  • Ability to learn quickly, build and maintain long-term relationships, and work with minimal supervision;
  • Strong written and verbal communication skills; strong analytical, organizational, and time management skills required
  • Office Microsoft 10 business, word, excel, cloud drives.

Salary: $65,000 per year.

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