Durable Medical Equipment Billing Specialist

Shan Medical Equipment Warehouse • Madison Heights, MI

411d

About The Position

The Durable Medical Equipment Billing Specialist at Shan Medical Equipment Warehouse is responsible for managing the billing process for durable medical equipment (DME) under the supervision of the Billing Manager. This role involves verifying sales orders, obtaining necessary authorizations, and ensuring compliance with CMS guidelines while providing excellent customer service to patients regarding their financial situations.

Requirements

• High school diploma or equivalent required.
• 3 years' experience in insurance billing required.
• Knowledge of electronic billing preferred.
• High attention to detail and ability to multitask.

Nice To Haves

• Experience with Brightree and various payor portals.
• Knowledge of the Medicare Appeals Process.
• Familiarity with NAVINET, Promise, UPMC, and CHC portals.

Responsibilities

• Perform complex clerical and accounting functions for patient billing.
• Bill all payors for DME items and rental items by verifying sales order information.
• Obtain authorization for billing when necessary, following CMS guidelines.
• Manage individual Revenue Cycle Management, resolving patient accounting problems.
• Issue and log Certificates of Medical Necessity and follow up on unpaid claims.
• Handle cash items and accounts receivable posting as needed.
• Confirm sales orders for rental and purchase items of DME by verifying proof of delivery and insurance details.
• Apply patient payments and upload tracking if applicable.
• Review prescriptions and edit pending or expired CMNs to send to physicians.
• Create validation rules and alerts for sales order creation.
• Check electronic inbound faxes for CMNs, EOBs, and progress notes.
• Work on various Revenue Cycle Management tasks including claim follow-up and denials.
• Process updated information for claims to ensure timely reprocessing.
• Maintain knowledge of HIPAA, OIG Compliance, medical coding, and billing/reimbursement guidelines.
• Resolve customer account discrepancies and monitor assigned accounts.
• Assist other departments in resolving billing issues.
• Bill secondary claims electronically or by paper and log CMNs.
• Communicate with personnel regarding non-compliance of documentation for proper billing.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED