Description

Manage the follow-up and resolution of outstanding claims from insurance carriers, third-party agencies, and patients.

This role is on-site.

Responsibilities

• Collect and resolve billed and unpaid DME claims for Commercial, Federal, and State insurance plans, plus private pay accounts.
• Monitor aged accounts receivable to ensure follow-ups meet payer turnaround-time standards.
• Track claim status via phone and online portals, responding to denials and composing appeals within specified timelines.
• Process adjustments, overpayments, and outstanding balances using Explanation of Benefits or Remittance Advice documents.
• Maintain HIPAA compliance and strict confidentiality of patient 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.
• Proven 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