DME Reimbursement Specialist

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

📋 Description

• Review of billing processes

• Generation of claims

• Management of accounts receivable and denial issues

• Oversight of unresolved claims

• Review of held or stopped revenue

• Examination and indexing of correspondence

• Reporting and reconciliation of all actionable work tasks

• Escalation and assignment of work exceptions to the appropriate parties

• Management of follow-up activities

• Support and coaching among peers

• Quality assurance checks

• Eligibility verification

• Prior authorization processes

• Intake procedures

• Posting of cash transactions

• Management of the inbound queue for order reviews and claims generation

• Quality review prior to the generation of claims

• Generation of claims within designated turnaround times

• Maintenance of download and production logs

• Tasking of exceptions

• Follow-up actions

• Review and analysis of denied claims

• Resolution actions for denied claims, which include, but are not limited to:

• Telephone inquiries regarding claim status

• Requests for reopening claims via telephone

• Review of medical and supporting documentation

• Handling of redeterminations and appeals

• Examination of scanned documentation received

• Analysis of documents and categorization into appropriate classes for follow-up

• Verification of eligibility or benefits

• Submission of prior authorization requests

⛳️ Requirements

• High School diploma or equivalent (GED)

• Minimum of 2 years of experience in DME/HME billing and collections

• Experience in managing intake, billing, collections, and cash posting

• Familiarity with the HDMS billing system

• Willingness to complete additional identity verification via ID.me

• Preferred knowledge of one or more additional DME/HME billing systems such as Brightree, TIMS, Bonafide, or CPR+

• Preferred experience in California insurance

🏝️ Benefits

• Health insurance coverage

• Gap insurance options

• Dental insurance plans

• Vision insurance availability

• Company-paid short-term and long-term disability insurance

• Company-paid term life insurance, with options for additional coverage

• Comprehensive suite of CHUBB supplemental insurance plans, including:

• Disability income insurance

• Level term life insurance

• Accident insurance

• Critical illness insurance

• Pre-paid legal services

• Flexible Spending Account (FSA) / Health Savings Account (HSA) with eligible plans

• 401K plan with company matching

• Floating holidays and paid time off