Apple Homecare Medical Supply - Richardson, TX
posted about 2 months ago
Full-time - Mid Level
Remote - Richardson, TX
Health and Personal Care Retailers
About the position
The Medical Claims Reimbursement Specialist at Apple HomeCare Medical Supply is responsible for managing and processing medical claims, ensuring accurate reimbursement for pediatric medical supplies. This role involves interpreting Explanation of Benefits (EOB), addressing underpayments, and handling appeals with various payers. The position is remote and requires a detail-oriented individual with a strong background in claims processing and insurance requirements.
Responsibilities
- Interpret Explanation of Benefits (EOB) and basic denial codes.
- Identify causes of denials and respond accordingly.
- Fill out reconsiderations and appeals with various government and commercial payers.
- Manage claim-related duties effectively.
- Meet performance metrics and team goals.
Requirements
- Experience with EOB and determining underpayments.
- Basic knowledge of Medicaid, Medicare, MCO, and commercial insurance claims filing requirements.
- Strong organizational and computer skills.
- Proficiency with Microsoft Office Suites.
- Analytical skills with attention to detail.
Nice-to-haves
- Experience with Brightree software.
- Background in Durable Medical Equipment (DME) or pediatrics.
Benefits
- Paid holidays
- Disability insurance
- Health insurance
- Dental insurance
- Paid time off
- 401(k) matching
- Life insurance
