DME Billing Specialist
The Breastfeeding Shop
full-time
Posted on:
Location Type: Office
Location: Emmaus • Pennsylvania • United States
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Salary
💰 $22 - $23 per hour
About the role
- Submit DME claims accurately and timely to Medicare, Medicaid, TRICARE, and commercial payers
- Ensure proper use of HCPCS codes , modifiers, units, and diagnosis codes
- Verify documentation requirements including prescriptions, CMNs, medical necessity, and proof of delivery (POD)
- Review Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs)
- Post payments, adjustments, and denials accurately
- Research, correct, and resubmit denied or rejected claims
- Manage payer follow-up for unpaid or underpaid claims
- Identify trends in denials and provide recommendations for process improvement
- Prepare and submit appeals with supporting documentation
- Monitor accounts receivable (AR) aging and prioritize follow-up
- Communicate with payers, clearinghouses, and internal teams to resolve issues
- Maintain accurate patient and payer records within the billing system
- Ensure compliance with CMS, Medicare, Medicaid, and payer-specific billing guidelines
- Stay up-to-date on changes in payer policies, fee schedules, and regulations
- Maintain HIPAA compliance and patient confidentiality at all times
Requirements
- 2-5 yrs. experience independently verifying medical insurance/coverage with all major insurance carriers.
- 2 plus years of billing and coding experience.
- High School Diploma or equivalent (G.E.D.) and 2-5 years’ insurance related experience.
- Excellent verbal and written communication skills.
- Strong inter-personal skills with the ability to effectively interact with co-workers and customers.
- Ability to multitask and prioritize assignments.
- Problem solving skills in standardized situations.
- Strong attention to detail with proven ability to work accurately and efficiently.
- Must be organized, flexible and adaptable to changing requests and requirements.
- High School Diploma or equivalent (G.E.D.)
- Experience using e-mail system for ongoing communication.
- Ring Central experience a plus.
- Salesforce and Brightree experience a plus.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
DME claims submissionHCPCS codingmedical billingcoding experienceclaims verificationEOB reviewpayment postingclaims resubmissionaccounts receivable managementappeals preparation
Soft Skills
verbal communicationwritten communicationinterpersonal skillsmultitaskingprioritizationproblem solvingattention to detailorganizationflexibilityadaptability
Certifications
High School DiplomaG.E.D.