Billing Support Specialist-DME
Quick Apply Full-time 1 day ago Full Job Description Position Summary University of Iowa Community HomeCare is growing! We are seeking a Billing Support Specialist to support our growing DME Business.
This position requires strong communication and interpersonal skills.
This person must be knowledgeable of insurance requirements and have the ability to determine medical justification through documentation to ensure proper reimbursement.
This position will assist in leading and coordinating and maintaining the proper insurance billing process and the professional reimbursement program to ensure compliance with current payments, rules, and legislative regulations that impact billing and collections, daily billing of claims, following up on Accounts Receivables and running/working scheduled reports.
Position Responsibilities Orders Reviews orders, proof of delivery, and required supporting documentation required to bill services.
Assures dates of service are correct and do not conflict with inpatient admission dates Enters projected renewal dates into the billing software system Follows financial policy guidelines Confirms sales orders after a thorough review of documentation Verifies insurance and obtains prior authorization as needed Logs CMN/physician orders into the billing software Document Tracking Ensure that all necessary documentation is obtained as it relates to payor requirements, standard operating procedures and compliance program Resolve any audits and denials from payors Resolve any held and pending work orders Reviews reports for patients needing annual renewals for orders and/or paperwork Initiates payor changes in a timely manner Adds clinical and billing alerts to the billing software system Documents information and any communication with patients, payors, and referral sources in the billing software system Maintains knowledge of any compliance with payor and regulatory standards Prior Authorizations/SMNs Monitors return of PA and resubmits as needed Monitors return of SMNs and resubmits as needed Contact Medicaid/MCOs regarding denials as needed Customer Service Contacts Establishes and maintains effective channels of communication and professional relationship with patients, physicians, co-workers, contractors, and outside facilities Interacts with other staff and patients to identify and resolve reimbursement issues and questions Contacts the physician's office regarding the information needed for patients to comply with insurance requirements for medical necessity.
Staff Education Provides education to staff as needed on order processes and issues.
Holds staff accountable for the accuracy of work.
Attends and participates in meetings Conveys changes in payor policies to other affected departments Physical/Cognitive Demands Ability to sit for long periods at a desk May require physical demands of lifting, reaching, stooping, walking, climbing stairs, etc.
Performs all pre-billing and billing efforts for durable medical equipment services.
Assures that dates of service, orders, and admission forms are present, complete, and accurate prior to billing Submits claims in a timely manner.
Submits claims electronically if possible Resubmits claims that have not been paid or paid incorrectly Meets goal of Days Sales Outstanding (DSO) of less than 40 days Monitors account receivable Prepares and reviews monthly reports Completes and document follow-up on all A/R older than 60 days Meets goal of A/R 120 days or older is less than 20%.
Manages refunds due to overpayment or duplication Interacts with other Home Care Staff and clients to identify and resolve reimbursement issues and questions.
Adds clinical or billing alerts to patient's EMR Utilizes strong customer services skills when working with patients on billing questions or issues Documents information discussed Performs Collections.
Monitors Collect Plus dashboard on a regular basis and provides feedback on patients moving to collections Updates addresses and information provided by Allegiance Group in CPR
Counsels patients in regard to payment plans Monitors payer rejections and reimbursement rates.
Assures payments are made according to fee schedules Identifies changes in payer guidelines and practices Takes corrective action Establishes and maintains relationships with third party payors, including remaining current on the industry and major payer activities and directives.
Develops a network of contacts/resources for major insurance companies Attends and participates in monthly reimbursement meetings Reads and reviews payer newsletters or websites Conveys changes in payer policies to other affected departments Performs other duties as assigned Education Requirements High School Diploma required Experience Requirements Strong computer skills and knowledge required Proficient in using technology and software applications Demonstrate the ability to communicate clearly in the English language both orally and in writing Excellent writing and analytical skills Capability to work independently and manage several projects simultaneously Must be detail-oriented, conscientious, and able to follow through Ability to adapt to a changing environment and handle multiple priorities Desired Qualifications 3-5 years experience billing/reimbursement experience with Durable Medical Equipment Brightree experience is a plus Knowledge of DME intake processes desired Quick Apply.
Estimated Salary: $20 to $28 per hour based on qualifications.
This position requires strong communication and interpersonal skills.
This person must be knowledgeable of insurance requirements and have the ability to determine medical justification through documentation to ensure proper reimbursement.
This position will assist in leading and coordinating and maintaining the proper insurance billing process and the professional reimbursement program to ensure compliance with current payments, rules, and legislative regulations that impact billing and collections, daily billing of claims, following up on Accounts Receivables and running/working scheduled reports.
Position Responsibilities Orders Reviews orders, proof of delivery, and required supporting documentation required to bill services.
Assures dates of service are correct and do not conflict with inpatient admission dates Enters projected renewal dates into the billing software system Follows financial policy guidelines Confirms sales orders after a thorough review of documentation Verifies insurance and obtains prior authorization as needed Logs CMN/physician orders into the billing software Document Tracking Ensure that all necessary documentation is obtained as it relates to payor requirements, standard operating procedures and compliance program Resolve any audits and denials from payors Resolve any held and pending work orders Reviews reports for patients needing annual renewals for orders and/or paperwork Initiates payor changes in a timely manner Adds clinical and billing alerts to the billing software system Documents information and any communication with patients, payors, and referral sources in the billing software system Maintains knowledge of any compliance with payor and regulatory standards Prior Authorizations/SMNs Monitors return of PA and resubmits as needed Monitors return of SMNs and resubmits as needed Contact Medicaid/MCOs regarding denials as needed Customer Service Contacts Establishes and maintains effective channels of communication and professional relationship with patients, physicians, co-workers, contractors, and outside facilities Interacts with other staff and patients to identify and resolve reimbursement issues and questions Contacts the physician's office regarding the information needed for patients to comply with insurance requirements for medical necessity.
Staff Education Provides education to staff as needed on order processes and issues.
Holds staff accountable for the accuracy of work.
Attends and participates in meetings Conveys changes in payor policies to other affected departments Physical/Cognitive Demands Ability to sit for long periods at a desk May require physical demands of lifting, reaching, stooping, walking, climbing stairs, etc.
Performs all pre-billing and billing efforts for durable medical equipment services.
Assures that dates of service, orders, and admission forms are present, complete, and accurate prior to billing Submits claims in a timely manner.
Submits claims electronically if possible Resubmits claims that have not been paid or paid incorrectly Meets goal of Days Sales Outstanding (DSO) of less than 40 days Monitors account receivable Prepares and reviews monthly reports Completes and document follow-up on all A/R older than 60 days Meets goal of A/R 120 days or older is less than 20%.
Manages refunds due to overpayment or duplication Interacts with other Home Care Staff and clients to identify and resolve reimbursement issues and questions.
Adds clinical or billing alerts to patient's EMR Utilizes strong customer services skills when working with patients on billing questions or issues Documents information discussed Performs Collections.
Monitors Collect Plus dashboard on a regular basis and provides feedback on patients moving to collections Updates addresses and information provided by Allegiance Group in CPR
Counsels patients in regard to payment plans Monitors payer rejections and reimbursement rates.
Assures payments are made according to fee schedules Identifies changes in payer guidelines and practices Takes corrective action Establishes and maintains relationships with third party payors, including remaining current on the industry and major payer activities and directives.
Develops a network of contacts/resources for major insurance companies Attends and participates in monthly reimbursement meetings Reads and reviews payer newsletters or websites Conveys changes in payer policies to other affected departments Performs other duties as assigned Education Requirements High School Diploma required Experience Requirements Strong computer skills and knowledge required Proficient in using technology and software applications Demonstrate the ability to communicate clearly in the English language both orally and in writing Excellent writing and analytical skills Capability to work independently and manage several projects simultaneously Must be detail-oriented, conscientious, and able to follow through Ability to adapt to a changing environment and handle multiple priorities Desired Qualifications 3-5 years experience billing/reimbursement experience with Durable Medical Equipment Brightree experience is a plus Knowledge of DME intake processes desired Quick Apply.
Estimated Salary: $20 to $28 per hour based on qualifications.
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