HME Biller

WVU Medicine•Home Work - Monongalia County WV (Local), WV

2d•Onsite

About The Position

The HME Collections Specialist is responsible for managing and resolving outstanding accounts receivables for patients and insurance companies in the home medical equipment industry. This role ensures timely and accurate billing and collection processes, maintains compliance with healthcare regulations and provides exceptional customer service to resolve payment issues.

Requirements

High school diploma or equivalent.
Current valid driver’s license.
Two (2) years’ experience working with collections, billing, or accounts receivable.
Strong communication skills.
Maintains knowledge of current trends with health care reform and reimbursement changes
Possess good interpersonal skills, organization, and leadership skills.
Ability to work independently and as part of a team.

Nice To Haves

Associate’s Degree or Bachelor’s degree in business, healthcare or related field.

Responsibilities

Monitor and manage accounts receivable reports, ensuring proper resolution of held or stopped claims to maintain cash flow and reduce outstanding balances.
Ensure claims are submitted within timely filing limits and implement strategies to address stop-gap issues that may delay reimbursement.
Process and update insurance information for existing patients with continuous rentals or periodic resupply needs to ensure accurate billing and claims submission.
Maintain current recertifications, prescriptions, and prior authorization for rental and period resupply patients ensuring compliance with payer requirements and uninterrupted equipment rentals.
Manage monthly billing for hospice accounts and quarterly billing for medical equipment facilities, ensuring timely and accurate submissions.
Analyze denial trends and collaborate on special projects to identify root causes and implement remediation strategies for claim resolution.
Monitors and verifies oxygen cylinder issues. Verifies Lot numbers and quantities are correct. Reports any deficiencies immediately to cylinder provide and obtain resolution. Performs random audits of lot numbers to verify tracking process is being followed.
Supports inventory management by performing visual checks and ensuring stock levels meet requirements.
Communicates with vendors to ensure timely shipment and resolve issues.
Maintains accurate records of serialized rental assets.
Researches special order requests and parts for patient owned equipment. Provides to pricing and HCPCS to appropriate staff to determine insurance coverage prior to ordering.
Tracks and reports on the concentrator preventive maintenance program including caped Medicare rental billing for maintenance at the appropriate interval.
Responsible for oxygen, equipment, and supply recalls following policy. Communicates promptly with management and staff regarding process to follow. Tracks and reports updates continually until recall is complete.