Under the guidance of the Home Medical Equipment Reimbursement Team Leader, performs duties related to the agency reimbursement from all funding sources. Individuals in this role may not perform all of these duties, or may perform additional, related duties not listed here.
1. Responsible for preparing and submitting claims to appropriate payer in a timely and accurate manner.
2. Monitors all output to assure the integrity of all claims for timely and accurate submission.
3. Furnishes statistical data for various reports used internally and externally according to agency policies and procedures.
4. Maintains a current knowledge of payer regulations regarding reimbursement.
5. Maintains a system to correct problems pertaining to reimbursement issues and claims status.
6. May assist with customer inquiries regarding account status, with response in 24 hours.
7. Resolves discrepancies and prepares adjustments and refunds as necessary.
8. Coordinates or acts as back-up for any new special billing situations.
Experience with billing reimbursement preferred.
This specific position will be working with our physician script and audit team in obtaining and verifying carrier required documentation prior to the billing process.