DME Account Specialist

Job SummaryMaintain accurate DME accounts, claims, payment posting, and follow-up in accordance with payer rules and organizational policies.Essential Duties and ResponsibilitiesVerify insurance eligibility and benefits and document findings without guaranteeing payment.Review orders, delivery evidence, medical-necessity documentation, and applicable authorization before billing.Prepare and submit accurate claims using applicable HCPCS codes, modifiers, and payer requirements.Post payments, reconcile balances, work denials and appeals, and track accounts receivable.Monitor rental billing cycles, documentation expirations, and recoupment risks.Escalate suspected overpayments, billing errors, and compliance concerns promptly.Compliance, Quality, and SafetyFollow applicable Medicare DMEPOS supplier standards, HQAA accreditation requirements, payer rules, and organizational policies relevant to assigned duties.Protect patient information under HIPAA and organizational privacy and security policies.Document work accurately and contemporaneously; report complaints, incidents, suspected fraud, and safety concerns through designated channels.Complete assigned orientation, competency assessments, emergency preparedness, infection prevention, and ongoing training.Minimum QualificationsMedical billing or revenue-cycle experienceKnowledge of Medicare DMEPOS billingPayer documentationConfidentialityBasic reconciliationEquivalent combinations of education, training, and experience may be considered where permitted.Performance ExpectationsPerformance is evaluated on accuracy, timeliness, service quality, documentation completeness, teamwork, safety, and applicable operational or financial metrics. Specific targets are set by management.Physical and Work RequirementsWork requirements vary by assignment. Reasonable accommodation will be considered consistent with applicable law. Driving, lifting, home visits, and equipment handling apply only where essential to the position.Great Benefits IncludeBlue Cross Blue ShieldState RetirementVacationHolidaysSick TimeDentalVisionShort and Long Term DisabilityDiscount Employee Pharmacy Program at our PharmacyClinic Visits at no cost to full-time employeesThis institution is an equal-opportunity employer and provider. All candidates who are extended an offer of employment will be required to undergo an FBI and Homeland Security background check and complete a drug screen.