Billing Specialist

The Billing Specialist is responsible for managing the full billing lifecycle for durable medical equipment (DME), ensuring accurate and timely claim submission and reimbursement. This position verifies billing documentation and coding accuracy, resolves claim rejections, supports secondary billing, and maintains compliance with payer and regulatory requirements. The role requires strong attention to detail, customer service skills, and the ability to manage multiple priorities in a fast-paced environment.

Key Responsibilities

• Prepare and submit claims via electronic systems and HCFA-1500 forms accurately and on time.
• Monitor billing queues and filing deadlines to ensure compliance with payer requirements.
• Review electronic claim rejections, correct errors, and resubmit claims promptly.
• Manage secondary billing and resubmissions.
• Follow up on pending accounts to ensure all required documentation is received prior to billing.
• Maintain daily productivity and department reporting.
• Deliver professional, high-quality customer service and communication.
• Collaborate with internal teams to resolve billing discrepancies.
• Perform additional duties as assigned.

Qualifications

• Minimum 3 years of medical billing experience; DME experience preferred.
• Working knowledge of ICD-10 coding; CPC certification preferred.
• Strong understanding of Medicare, Medicaid, commercial insurance, and payer requirements.
• Knowledge of medical terminology, insurance benefits, and reimbursement processes.
• Experience working with billing clearinghouses (e.g., Waystar).
• Proficiency with Microsoft Word and Excel.
• Ability to learn proprietary billing and document management systems.
• Strong organizational, analytical, and problem-solving skills.
• Excellent written, verbal, and customer service communication skills.