Prochant is the leading reimbursement firm with a dedicated focus on HME and pharmacy.
DME Reimbursement Specialist
Location
United States
Posted
2 days ago
Salary
0
Seniority
Mid Level
Job Description
DME Reimbursement Specialist
Prochant
• Billing Review • Claim Generation • A/R & Denial Management • Unaddressed Claim Management • Stop/Held Revenue review • Correspondence review and Indexing • Reporting and reconciliation of all executable work tasks • Escalations/tasking of work exceptions to appropriate parties • Management of follow-ups • Peer support/Peer coaching • Quality Assurance • Eligibility • Prior Authorization • Intake • Cash posting • Manage inbound queue of orders to be reviewed/claims to be generated • Quality review prior to claim generation • Claim generation within specified turnaround time • Maintenance of downloads and production logs • Exception Tasking • Follow Ups • Denied claim review and analysis • Denied claim resolution action including, but not limited to: • Telephone claim status requests • Telephone re-opening requests • Medical documentation/Supporting documentation reviews • Redeterminations and appeals • Review of inbound scanned documentation • Analysis of documents and assignment to appropriate document classes (for follow up) • Eligibility or benefit verification • Prior authorization submission
Job Requirements
- High School diploma or GED
- 2+ years DME / HME billing & collections experience
- Experience managing intake, billing, collections, and cash posting
- Knowledge of the HDMS billing system
- Willingness to undergo additional identity verification through ID.me
- Knowledge of one or more of the following additional DME / HME billing systems: Brightree, TIMS, Bonafide, or CPR+ preferred
- California Insurance experience preferred
Benefits
- Health Insurance
- Gap Insurance
- Dental Insurance
- Vision Insurance
- Short Term / Long Term Disability (company paid)
- Term Life Insurance (company paid, employee can elect additional)
- Full suite of CHUBB supplemental insurance plans including:
- Disability Income
- Level Term Life
- Accident Insurance
- Critical Illness Insurance
- Pre-Paid Legal
- FSA / HSA with eligible plans
- 401K with company match
- Floating holidays and paid time off
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