DME Billing Specialist

Job Summary: Bills Secondary and/or Tertiary payors and/or individuals. Pursues collection of all accounts receivable until payment is made or until account is deemed uncollectible.

Major Responsibilities/Activities:

• Works with state entities such as Medicaid and other Insurance carriers. Has regular contact with facilities and responsible parties.
• Prepares and submits facility claims to Medicaid, and other Insurance carriers either electronically or by hard copy billing.
• Runs eligibility and benefit verifications to ensure accurate payor is being billed.
• Secures needed medical documentation required or requested by Medicaid, or other Insurance carriers.
• Monitors and tracks Medicaid Pending as related to Secondary/Tertiary billing.
• Monitors and follows up on unpaid claims with Medicaid and other Secondary/Tertiary payors until claims are paid.
• Processes denials and/or rejections or corrects any billing errors and resubmits claims to Medicaid, and/or third party insurance carriers.
• Prepares and submits statements and/or necessary collection letters to individuals
• Works closely with private individuals to negotiate payment plans for accounts in collections.
• Maintains account status in vendor software.
• Maintains and gathers information necessary for uncollectible account to be processed for write off.
• Researches billing and benefit changes for Medicaid, and other Insurance carriers.
• Participates in weekly and monthly accounts receivable meetings.
• Maintains confidentiality of all protected health information (PHI).
• Completes work timely to ensure compliance with departmental standards.
• Performs other duties as required.

Competencies: To perform the job successfully, an individual should demonstrate the following competencies to perform the essential functions of this position. Adaptability – the individual adapts to changes in the work environment, manages competing demands and is able to deal with frequent change, delays or unexpected events

• Analytical – the individual synthesizes complex or diverse information
• Customer service – the individual manages difficult client/customer situations, responds promptly to customer needs, solicits customer feedback to improve service, responds to request for service and assistance and meets commitments
• Dependability – the individual is consistently at work and on time, follows instructions, responds to management direction and solicits feedback to improve performance
• Judgment – the individual displays willingness to make decisions, exhibits sound and accurate judgment and makes timely decisions
• Oral communication – the individual speaks clearly and persuasively in positive or negative situations and demonstrates group presentation skills.
• Planning/organizing – the individual prioritizes and plans work activities, uses time efficiently and develops realistic action plans
• Problem solving – the individual identifies and resolves problems in a timely manner and gathers and analyzes information skillfully
• Quality management – the individual looks for ways to improve and promote quality and demonstrates accuracy and thoroughness
• Quantity – the individual meets productivity standards and completes work in a timely manner

Minimum Requirements: DME Billing Experience Possession of a high school diploma or equivalent.
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• Possession of strong organizational skills.
• Excellent verbal and written communication skills.
• Ability to work independently on assigned tasks as well as to accept direction on given assignments.
• Ability to work under stress, with interruptions and deadlines.
• Able to work collectively with the administrative team associates.
• Proficient knowledge of Excel, Microsoft Word, and basic computer knowledge.
• Ability to manage several complex projects simultaneously while working under pressure to meet deadlines.

Job Type: Full-time

Job Type: Full-time

Schedule:

• Monday to Friday

Work Location: One location