DME Billing and Care Specialist (Remote In FL & GA)
Job Summary
The DME Billing and Care Specialist is a dynamic role, combining superior customer service and expert billing practices to ensure high efficiency in patient orders and customer satisfaction. This position is designed for experienced professionals who can balance the immediate needs of patients with the financial processes required for service provision. The ideal candidate will possess strong organizational and problem-solving skills.
Essential Duties and Responsibilities
Patient Care and Support:
Verify patient insurance coverage and eligibility.
Review medical records and documentation to determine the need for prior authorization.
Provide guidance and support to operations personnel.
Submit prior authorization requests to insurance companies and follow up on pending authorizations.
Provide updates to patients and healthcare providers regarding authorization statuses.
Collaborate with healthcare providers to gather necessary information for authorization requests.
Maintain accurate records of all prior authorization activities.
Stay up to date with insurance policies and guidelines related to prior authorizations.
Communicate with insurance companies to resolve any issues or discrepancies.
Write reports, business correspondence, and procedure manuals as needed.
Ensure compliance with applicable laws and regulations.
Billing and Financial Processes:
Process billing for dispensed equipment, ensuring accuracy and compliance with payer requirements.
Handle inquiries and issues related to billing and payments from providers and patients.
Reconcile billing records with payments received and address any discrepancies promptly.
Develop and maintain relationships with providers, ensuring they are treated as valued clients.
Ensure timely and accurate billing submissions to maximize revenue and reduce the risk of non-payment.
Understand and apply ICD-10 coding and insurance verification processes.
Minimum Qualifications
3+ years of experience as a DME Care Coordinator or equivalent.
2+ years of experience in medical billing, preferably in a DME or healthcare setting.
High school diploma or equivalent required; Associate degree preferred.
Solid understanding of operational processes and systems.
Excellent leadership skills.
Strong problem-solving and analytical skills.
Excellent communication and interpersonal skills.
Strong knowledge of medical terminology, ICD-10 coding, and insurance verification processes.
Familiarity with HIPAA regulations and patient privacy laws.
Excellent attention to detail and organizational skills.
Ability to work independently and prioritize tasks effectively.
Proficient in Microsoft Office and other related software.
Prefer strong negotiation skills.
Intermediate knowledge of medical terminology and DME.
Ability to handle high-pressure situations effectively.
Experience working with workers' compensation insurance.
Candidate Skills
Positive attitude and willingness to treat every patient and provider like a member of your family.
Good interpersonal and verbal communication skills.
Must have good written communication skills.
Ability to effectively present information and respond to questions from peers and management.
Ability to multi-task and stay organized.
Ability to handle high-pressure environments.
Strong desire to provide excellent customer service.
High ethical and professional standards of conduct.
An attitude of continuous improvement in professional performance.
Job Type: Full-time
Pay: $22.00 - $28.20 per hour
Benefits:
401(k)
Health insurance
Paid time off
Schedule: 8 hour shift
Work Location: Remote (Florida & Georgia only)
