DME Billing Specialist

$34,278 - $36,400/Yr

Brightree Pte Ltd - Peachtree Corners, GA

Full-time - Entry Level

Peachtree Corners, GA

Professional, Scientific, and Technical Services

About the position

The DME Billing Specialist at Brightree plays a crucial role in ensuring the success of the Billing Center by performing quality assurance tasks. This position involves analyzing medical documentation, ensuring compliance with insurance guidelines, and optimizing claim processing to improve revenue cycle practices. The specialist will also be responsible for creating and modifying standard operating procedures and conducting audits on transactions processed by internal teams.

Responsibilities

• Learn multiple insurance guidelines and specific durable medical equipment requirements for Medicare, National Commercial, and Medicaid plans.
• Ensure quality confirmation for optimal claim processing and analyze sales order trending issues.
• Escalate quality-related issues immediately.
• Analyze medical documentation to qualify patients for equipment, supplies, or testing ordered by providers.
• Conduct random audits on all transactions processed by internal teams and communicate and track trended results.
• Escalate quality-related issues, errors, trainings, and support to internal and external teams in a timely manner.
• Create and modify Standard Operating Procedures (SOP) and Workflow systems for specific payor and/or client rules.
• Implement and adhere to policies, procedures, and systems within Brightree systems.
• Ensure accuracy to optimize reimbursement while adhering to company policies and maintaining compliance.
• Complete tasks in a timely manner and perform other tasks as assigned.

Requirements

• High School diploma required, college coursework a plus.
• 2 years of durable medical equipment and insurance billing experience.
• Strong communication skills and ability to multi-task.
• Capable user of Microsoft Office products including Outlook, Excel, Word, and PowerPoint.
• Knowledge of remote collaboration tools: Zoom, Go-To Meeting, Microsoft Teams, and SharePoint.
• Knowledge of Power Mobility, Sleep Studies, and CGMs.
• Brightree software knowledge or equivalent combination of education and experience.

Nice-to-haves

• Experience with medical billing software other than Brightree.
• Familiarity with healthcare compliance regulations.

Benefits

• Commuter assistance
• Health savings account
• Caregiver leave
• AD&D insurance
• Employee stock purchase plan
• Paid holidays
• Disability insurance
• Health insurance
• Dental insurance
• 401(k)
• Flexible spending account
• Tuition reimbursement
• Paid time off
• Employee assistance program
• Vision insurance