Customer Service Billing Specialist I

This is a fully remote position, open to applicants in California.

📋 Description

• Act as the main onshore contact for patient and customer inquiries, addressing concerns at the first point of contact when feasible while handling a high volume of calls and adhering to strict service-level requirements.

• Provide quick, professional, and compassionate support through effective verbal and written communication, including de-escalating sensitive or complex issues to achieve favorable results.

• Respond to and direct inquiries from patients, clerical personnel, insurance providers, and internal teams, escalating complex matters, payer discrepancies, denial trends, or systemic issues when necessary.

• Utilize knowledge of medical terminology, basic anatomy, orthopedic diagnoses, and ICD-10 coding guidelines daily for claim and inquiry resolution.

• Protect sensitive information, including PHI, while ensuring adherence to HIPAA, government healthcare regulations, SOPs, and internal procedures.

• Work collaboratively with both onshore and offshore teams to guarantee smooth call transfers, documentation, follow-up, and continuity of service.

• Prepare, review, submit, and resubmit DME and DMEPOS claims for accuracy and completeness, acquiring any missing information and ensuring clean claim submission in collaboration with the Health Information Management (HIM) team.

• Confirm correct payor selection, eligibility, benefits, and necessary authorizations or pre-authorizations using insurance carrier portals and internal systems.

• Support compliance initiatives by serving as the onshore resource for patient-related inquiries, facilitating appropriate restrictions on PHI access for offshore teams.

• Handle multiple accounts, payors, and priorities simultaneously, showcasing strong organizational skills, adaptability, and attention to detail in a dynamic work environment.

• Meet daily, weekly, and monthly productivity, quality, and scorecard targets while contributing to team objectives and service continuity, including covering for PTO when needed.

• Acquire knowledge and assist with additional billing and service functions as necessary to ensure operational coverage and consistency.

• Uphold a professional demeanor in all internal and external relationships that positively influence the company's reputation and comply with the organization's policies and practices. Commit to embodying Breg’s cultural beliefs and achieving key company objectives.

• Advocate for Breg's culture within the organization by utilizing established methods such as storytelling, focused feedback, and recognition.

⛳️ Requirements

• High School diploma or equivalent is required.

• At least 1 year of recent experience in medical billing is required; experience with DMEPOS is preferred.

• Familiarity with various payor groups is preferred.

• Understanding of Current Procedural Terminology (CPT), ICD-10, and Healthcare Common Procedure Coding System (HCPCS) coding, as well as insurance billing regulations.

• Relevant professional certification (e.g., Medical Reimbursement Specialist, Billing and Coding) is preferred.

• Proficient in computer use, including web browsing/internet searching, practice management technology, Microsoft (MS) Outlook, Word, Excel, Teams, and PowerPoint.

• Capability to thrive in a fast-paced environment while maintaining composure and professionalism.

• Ability to ensure consistent, regular attendance and punctuality.

🏝️ Benefits

• Medical, dental, vision, disability, and life insurance, effective the first of the month following hire.

• Paid Time Off (PTO) and company-paid holidays.

• Opportunities for professional growth within a company that appreciates your contributions.

• Commitment to Diversity & Inclusion: Breg is proud to be an Equal Employment Opportunity employer, promoting a diverse and inclusive workplace.