Description

You will manage the accurate follow-up and resolution of outstanding claims from insurance carriers, third-party agencies, and patients.

Responsibilities

• Collect billed and unpaid DME claims related to Commercial, Federal, and State insurance plans, and private pay accounts.
• Monitor and minimize aged accounts receivables while ensuring follow-up meets payer turnaround-time standards.
• Obtain and track claim status via phone and online portals, responding to denials and composing appeals within specified timelines.
• Process adjustments, overpayments, and outstanding balances based on Explanation of Benefits or Remittance Advice documents.
• Maintain HIPAA compliance and strict confidentiality of patient personal information.

Required Skills

• 5+ years of direct experience in medical claims billing, collections, insurance, appeals, or authorizations.
• Bachelor's degree or equivalent work experience in a healthcare-related setting.
• Experience managing claims for Commercial, Federal, and State insurance plans.
• Proficiency with word processing and spreadsheet software.
• Strong verbal and written communication skills for coordinating with insurance representatives.
• Ability to review and release rental agreement holds.
• Understanding of federal, state, and local standards, guidelines, and regulations.

Preferred Skills

• Durable Medical Equipment (DME) claim processing experience.

Key Skills

Education

Bachelor's degree