License Required or Eligible
3 years of experience required
Job Summary: Reviews orders prior to confirmation to verify accuracy and compliance with third party payment requirements. Identifies potential reimbursement problems and resolves prior to approving delivery of products/or equipment. Tracks outstanding CMNs and authorizations. Works with physician offices and payers to obtain required medical necessity documentation for claim filing. Instructs DME staff on the financial liability of the patient and the reimbursement that should be collected at time of delivery. Ensures data entry has been completed accurately including financial history, insurance, diagnosis, physician, HCPC codes, billing arrangements, assignment, modifiers and CMN. Maintain knowledge of all contracted third party payer claim filing guidelines.
Education: High school graduate, GED or equivalent required. Associates degree in related field preferred, preferably in Computer & Information Science, Business, Communications or Health Information Management.
Licensure: Current, valid drivers license and acceptable driving record required upon hire and to be maintained during employment. Must also have reliable transportation to make visits to assigned locations
Experience: Requires at least 3-5 years of experience in the field of healthcare or medical billing.