Billing Support Specialist

Billing Specialist

The Billing Specialist is a generalist within the Billing Support department. The position works across CMN coordination, insurance verification and authorization, documentation follow-up, order review, claim readiness, and internal billing support. Billing Specialists manage assigned work queues from identification through resolution, communicate with physician offices, payers, patients, and internal teams, and document each action clearly in the appropriate system.

This role does not require prior DME billing or CMN experience. Kubat will train the selected employee on respiratory products, payer rules, and departmental procedures. Success depends primarily on accuracy, persistence, organization, sound judgment, learning agility, and personal ownership of unresolved work.

Core Accountabilities

1. Patient File and Claim Readiness

Primary outcome: Patient files contain the complete and accurate information required for service, shipment, and timely claim processing.

• Review patient orders, payer information, eligibility, authorizations, CMNs, physician documentation, medical-necessity support, and other required records for completeness and accuracy.
• Identify missing, expired, inconsistent, or unsupported information and take the required action before the issue delays patient service or billing.
• Enter and maintain accurate patient, order, authorization, and documentation information in Brightree and other approved systems.
• Apply current procedures and payer requirements consistently while escalating unclear or unusual cases for guidance.

2. Work Queue Ownership and Follow Through

Primary outcome: Every assigned item has a current status, responsible owner, documented next action, and follow-up date until it is completed or properly escalated.

• Manage assigned queues and reports, prioritize work by patient need, deadline, aging, financial risk, and likelihood of resolution.
• Contact physician offices, insurance companies, patients, and internal departments to obtain missing information, signatures, corrections, approvals, or clarification.
• Follow up persistently and professionally until each item is resolved. Repeated outreach must be documented and escalated when ordinary follow-up does not produce a result.
• Maintain accurate notes, statuses, next actions, and follow-up dates so another employee or leader can understand the case without reconstructing its history.
• Meet established productivity, turnaround, accuracy, attendance, and service expectations.

3. Billing Issue Prevention and Resolution Support

Primary outcome: Upstream file problems are corrected quickly and recurring causes of held claims, denials, rework, delayed cash, or writeoffs are reduced.

• Investigate documentation, authorization, eligibility, order, CMN, or data issues that prevent a claim from being submitted or resolved.
• Provide the Revenue Cycle Manager and Patient Care Operations with complete documentation and corrections needed for claim follow-up, resubmission, or appeal.
• Recognize recurring errors, communicate the pattern to the appropriate lead or manager, and assist with corrective action that prevents repetition.
• Cross-train across Billing Support functions and shift between CMN, authorization, documentation, and billing-readiness work as departmental priorities change.
• Protect patient confidentiality and comply with HIPAA, payer requirements, approved policies, and audit standards.

Required Qualifications

• High school diploma or equivalent.
• Demonstrated success completing detailed, deadline-driven administrative, claims, financial, insurance, customer-operations, or comparable work.
• Ability to manage a work queue independently, maintain accurate records, prioritize competing deadlines, and follow unresolved items through completion.
• Strong attention to detail with the judgment to recognize missing or inconsistent information.
• Professional and persistent communication skills, including comfort making repeated follow-up contacts when necessary.
• Ability to learn detailed rules, software, and workflows and apply them consistently.
• Reliable attendance and demonstrated follow-through on assigned responsibilities.

Preferred but Not Required

• Experience in healthcare administration, insurance, claims, prior authorization, medical records, billing support, collections, credentialing, or another regulated process environment.
• Experience using an EMR, billing platform, case-management system, CRM, or comparable work-queue software.
• Familiarity with Medicare, Medicaid, commercial insurance, medical documentation, CMNs, or DME/HME.

Prior DME billing, respiratory billing, or CMN coordination experience is not required and should not substitute for demonstrated execution, accuracy, persistence, and accountability.

Physical and Work Requirements

• Ability to work in an office or remote administrative environment as assigned, with regular computer and telephone use.
• Prolonged periods of sitting and computer work, with frequent review and entry of detailed patient and payer information.
• Ability to communicate regularly with physician offices, payers, patients, and internal teams.
• Ability to occasionally lift or move office materials weighing up to 25 pounds, with assistance when appropriate.
• Regular and reliable attendance during the assigned work schedule.

Equal Employment Opportunity and Job Description Notice

KUBAT HEALTH CARE IS AN EQUAL OPPORTUNITY EMPLOYER

The statements herein describe the general nature and level of work being performed and are not an exhaustive list of responsibilities, duties, and skills required of personnel so classified. This job description does not establish a contract for employment and may be changed at the discretion of the employer.