Billing Specialist

About the role

Rapidly growing and successful national medical equipment manufacturer and provider seeking an experienced Billing Specialist to work with Medicare, Medicaid, Commercial Insurance companies and customers for claims submission and follow up. The role requires experience in medical billing and claims processing, skilled in investigating and appealing denied claims, with preference for experience with Medicare, Medicaid and Commercial payers. This position reports to the Billing Supervisor. The role is full time, exempt and located at our Dallas, TX Facility with a hybrid schedule requiring onsite work 3 days a week.

Essential Duties And Responsibilities

• Ensure timely and accurate billing of claims via electronic or paper to Medicare, Medicaid, and Commercial Insurances in accordance with policy using primarily Niko Health claim submission software and Salesforce
• Work with all payers to ensure medical claims are being processed timely and paid accurately
• Analyze and post EOB payments and denials in all billing systems, ensuring correct processing and payment
• Determine root cause and prevention of future rejections & denials, advising management and appeals team where necessary
• Route claims and/or balances that are deemed uncollectible to Financial Patient Responsibility Review or Write Off Queues timely and appropriately
• Assist and communicate effectively with our patients, doctors, customers, and coworkers with billing inquiries at the highest-level support possible
• Able to Identify process improvement opportunities and recommend potential solutions to improve departmental workflow
• Assist with any other duties or projects on an as needed basis
• Maintain regular and punctual attendance
• Comply with all company policies and procedures, HIPAA and all state and federal regulations
• Must meet or exceed production & quality KPI standards

Minimum Qualifications

• High School diploma or equivalent, required
• Some College and/or medical billing certificate, preferred
• 2 years of Medicare, Medicaid and/or Commercial Insurance experience, particularly in HME, highly preferred
• Intermediate knowledge/proficiency in Microsoft Office products and Salesforce, highly preferred
• A combination of training, education and experience that is equivalent to the qualifications listed above and that provides the required knowledge, skills, and abilities required

Knowledge, Skills And Abilities

• A comprehensive understanding of Medicare, Medicaid, and/or Commercial Insurance program rules as it pertains to DME billing
• Ability to take direction and communicate effectively with customers and employees at all levels of the organization
• Ability to thrive in a fast-paced and dynamically changing organization
• Must have a strong work ethic
• Excellent oral and written communication skills required
• Strong attention to detail
• Ability to prioritize and manage daily responsibilities effectively
• Solutions-oriented problem solver
• Excellent planning, communication and organizational skills

Core Competencies

• Continuous Improvement, Problem Solving, Service Focus, Collaboration, Team Communication, Change Agility, Mission & Vision Focus, Stewardship

Pay

$55,000 - $60,000 USD per year