Medical Billing Specialist

Job Description

Job Description

Medical Biller – Medicare & DME
Oakland Gardens, NY

• Full-Time | On-Site | Monday–Friday, 9:00 AM–5:30 PM

Are you an experienced Medical Biller who knows Medicare, DME billing, and insurance follow-up—and also knows how to provide great customer service?

We’re looking for a detail-oriented, persistent Medical Biller / Billing Specialist who can confidently manage claims, resolve denials, work directly with insurance carriers, and communicate professionally with patients regarding coverage, reimbursement, and account balances.

This is a hands-on billing role for someone who understands that successful medical billing requires both strong technical knowledge and excellent follow-through with people.

This is a 100% on-site position. Remote work is not available.

WHAT YOU’LL DO:

• Process Medicare, Medicaid, commercial insurance, third-party, DME, and Home Health Agency billing
• Follow up on outstanding claims, payments, collections, eligibility, remittances, and appeals
• Communicate daily with Medicare, Medicaid, commercial insurance carriers, third-party payers, and patients
• Research and resolve denied, rejected, delayed, and unpaid claims
• Troubleshoot complex pharmacy and DME reimbursement issues
• Review A/R aging reports and aggressively follow up on outstanding balances
• Help ensure outstanding claims do not exceed 90 days
• Reconcile outstanding receivables for DME products
• Post required Medicare and Medicaid information into the pharmacy operating system
• Maintain complete and accurate patient account documentation
• Contact patients regarding insurance reimbursement, balances, and payment information
• Process credit card payments and establish monthly patient payment plans
• Handle paper billing for primary and secondary pharmacy claims
• Review prescriptions to help confirm items are covered by CMS or the appropriate third-party payer
• Answer calls regarding Medicare, Medicaid, commercial insurance, and third-party reimbursement
• Support workflow and performance-improvement initiatives

WHAT WE’RE LOOKING FOR:
Required:

• At least 4+ years of Medicare billing experience
• At least 3+ years of DME billing experience
• Strong knowledge of Medicare Part B and third-party payment systems
• Working knowledge of Medicare and Medicaid billing regulations and requirements
• Experience with claim follow-up, denials, appeals, reimbursement, and A/R
• Strong customer service and interpersonal skills
• Ability to communicate professionally with patients and insurance carriers
• Excellent attention to detail and documentation
• Strong follow-through—you don't let unresolved claims or issues fall through the cracks
• Ability to manage multiple priorities and meet deadlines
• Experience with Microsoft Office, including Excel, Word, Outlook, PowerPoint, and Teams
• High school diploma or equivalent preferred

A Plus:

• Pharmacy reimbursement experience
• Knowledge of state, federal, and commercial pharmacy reimbursement
• Experience with MicroMerchant
• Experience with QS/1

THE RIGHT PERSON FOR THIS ROLE:

• You may be a great fit if you're someone who enjoys solving billing problems, tracking down answers, talking with insurance companies, and helping patients understand what happens next.
• We're looking for someone who is organized, accountable, comfortable working independently, and persistent enough to follow a claim through until the issue is resolved.

SCHEDULE & WORK LOCATION:

• Monday–Friday
• 9:00 AM–5:30 PM
• Full-Time
• On-Site Only – No Remote

BENEFITS:

• 401(k)
• Health insurance
• Dental insurance
• Vision insurance
• Paid time off
• Employee discount

If you have strong Medicare and DME billing experience and take pride in providing excellent customer service, we’d like to hear from you. Apply today.

We are an equal opportunity employer, and we are an organization that values diversity. We welcome applications from all qualified candidates, including minorities and persons with disabilities.

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