Billing Specialist

Since our doors opened in 1989, Reliable Medical has been committed to improving the lives of all who entrust us with their care and those who we entrust to provide it. We strive to be the premier provider of complex mobility solutions and other critical services for customers seeking compassionate care and optimal outcomes. Our mission is to improve the lives of those we serve by providing best in class service to customers, education, product expertise and dedicated partnership to clinicians, and development, career satisfaction and work-life balance to our team members. We aspire to bring our mission to new communities and to reinvest our growth into improving lives, treating one another and our customers, like family. Brief Description The Billing Specialist is responsible for managing and processing medical billing activities to ensure accurate and timely reimbursement. This role requires a thorough understanding of insurance requirements, regulatory guidelines, and medical billing procedures. The Billing Specialist ensures compliance with all relevant regulations, handles claims submissions and denials, and communicates effectively with internal and external stakeholders. This position demands strong organizational skills, attention to detail, and proficiency in billing software. Essential Functions Communicate effectively with the Billing Supervisor, keeping them informed of departmental needs and trends in documentation and claim rejections. Adhere to the professional reimbursement program to ensure compliance with current payment rules, legislative regulations, HIPAA, JCAHO, and Compliance standards. Monitor current reimbursement and payment rules, anticipating and communicating legislative and regulatory changes impacting medical billing to the company. Review authorizations, detailed prescriptions, and claim verifications within the work group to ensure accurate and clean claims are submitted for revenue. Review and bill equipment charts and delivery tickets for completeness according to insurance payment guidelines, ensuring all appropriate modifiers and authorization numbers are included on the sales order/invoice for claim submission. Ensure timely billing of all orders within 72 hours of the billing task creation to meet daily goals. Work billing rejection and batch exceptions as assigned. Perform other duties as assigned by management. Qualifications And Requirements High school diploma or equivalent. Minimum of 1-2 years of experience in medical billing, or relevant education. Durable Medical Equipment (DME) experience required. Experience with Brightree preferred. Background in a healthcare-related industry. Knowledge of insurance requirements and policy guidelines. Ability to determine medical justification by reviewing documentation. Strong time management skills. Excellent communication skills for dealing with referral sources and physician offices. Proficiency in operating billing software and patient portals. Ability to type over 30 words per minute and navigate computer programs accurately and efficiently. Competencies Attention to Detail: Ability to review and ensure the accuracy of billing documentation and claims. Communication Skills: Effective verbal and written communication with team members, referral sources, and physician offices. Technical Proficiency: Skilled in using billing software, patient portals, and other relevant computer programs. Time Management: Efficient in managing time to meet billing deadlines and daily goals. Problem-Solving: Capability to identify issues in claims, work on denials/rejections, and implement corrections. Regulatory Compliance: Knowledgeable in HIPAA, JCAHO, and compliance regulations, ensuring all actions adhere to these standards. Customer Service: Provide excellent service and support to both internal and external stakeholders. Adaptability: Ability to stay updated with changes in reimbursement/payment rules and industry trends, and to adjust processes accordingly. Organizational Skills: Maintain an organized workflow and manage multiple tasks effectively. Team Collaboration: Work well within a team environment, supporting colleagues and contributing to departmental goals. Physical Requirements Prolong periods sitting at a desk and working on a computer. Must be able to lift up to 15 pounds at times. Our Commitment to you Work-Life Balance and Flexibility: Enjoy a guaranteed 40 hours per week, with no weekends required. Comprehensive Health Coverage: We provide excellent health, dental, and vision insurance coverage to prioritize the well-being of yourself and your family. Generous Paid Time Off: Maintain a healthy work-life balance with our generous PTO policy, including vacation days and paid holidays. Professional Development Opportunities: Grow your skills and advance your career with access to professional development opportunities including education programs, ongoing training, company sponsored workshops/events. Retirement Savings Plan: Prepare for your future with our 401(k) retirement savings plan, which includes company matching contributions. Wellness Programs: Participate in our wellness initiatives, such as wellness challenges and access to mental health resources, to support your overall well-being. Inclusive and Diverse Workplace: Be part of an inclusive team where everyone's contributions are valued and respected. Volunteer Opportunities: Additional paid time off to volunteer and support community initiatives. This benefit is known as “VTO – Volunteer Time Off”. Employee Recognition Programs: Awards and celebrations for outstanding achievements. Service Awards: Recognition for long-term employees with milestone rewards. Parental and Childbirth Leave: Receive support and time off for parental and childbirth leave to prioritize family needs during significant life events. At Reliable Medical, we prioritize your well-being and growth, providing benefits that make your career journey both rewarding and fulfilling. Join us and experience the difference! Reliable Medical is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, disability, age, veteran status, or other characteristics. #J-18808-Ljbffr