DME Pharmacy Billing Specialist

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

📋 Description

• Assess DME billing for precision, adherence to compliance, and alignment with payer standards.

• Confirm and amend HCPCS codes, quantities, chart notes, and necessary documentation.

• Process claims and follow up on outstanding claims, rejections, and denials until resolved.

• Utilize Frameworks LTC, ECM, and Medbill to handle and oversee DME claims.

• Engage with pharmacists, technicians, healthcare professionals, insurance providers, and pharmacy teams across various locations.

• Detect billing discrepancies, suggest corrections, and assist in enhancing claim precision and workflow efficiency.

• Carry out other related tasks as assigned.

⛳️ Requirements

• In-depth understanding of DME billing, Medicare Part B, and Medicaid billing regulations.

• Capability to interpret payer guidelines and apply them correctly to claim evaluation and submission.

• Exceptional verbal and written communication abilities.

• Keen attention to detail and commitment to following up on pending items until they are resolved.

• Proficiency in Frameworks LTC and ECM.

• Experience with Medbill is preferred.

• At least 1 year of experience in a retail or long-term care pharmacy setting; 2+ years is preferred.

• 1-3 years of DME billing experience is necessary.

• Experience in resolving denied or unpaid DME claims is highly desirable.

• Must be capable of enduring extended periods of computer screen time.

• Repetitive motion desk tasks.

🏝️ Benefits

• Competitive salary.

• Comprehensive healthcare benefits.

• 401(k) retirement plan.

• Paid time off.

• A fantastic work environment.

• Opportunities for career advancement and growth.