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DME Billing Specialist

Location: Raleigh, NC

Job Summary

We are seeking a detail-oriented and experienced DME Billing Specialist to join our team. The ideal candidate will be responsible for managing the billing process for Durable Medical Equipment (DME), ensuring timely claim submission, payment processing, denial resolution, and compliance with payer guidelines. This role requires strong knowledge of insurance billing, Medicare and Medicaid regulations, and excellent customer service skills.

Key Responsibilities

· Process and submit claims for Durable Medical Equipment (DME) accurately and promptly.

· Verify patient insurance eligibility, benefits, and authorization requirements.

· Review physician orders and supporting documentation to ensure billing compliance.

· Monitor claim status and follow up on unpaid, denied, or rejected claims.

· Resolve billing discrepancies and initiate appeals when necessary.

· Post payments, adjustments, and reconcile patient accounts.

· Communicate with insurance carriers, patients, and healthcare providers regarding billing matters.

· Maintain accurate records of billing activities and account status.

· Ensure compliance with Medicare, Medicaid, commercial insurance, and company policies.

· Assist with accounts receivable management and collections activities.

· Prepare and maintain reports related to billing performance and reimbursement trends.

Qualifications

· High school diploma or equivalent.

· Minimum of 1-2 years of medical billing or DME billing experience.

· Knowledge of Medicare, Medicaid, and commercial insurance billing procedures.

· Familiarity with HCPCS, ICD-10, and CPT coding.

· Proficiency in billing software, Microsoft Office Suite, and electronic medical records (EMR/EHR) systems.

· Strong analytical, organizational, and problem-solving skills.

· Excellent verbal and written communication skills.

· Ability to manage multiple priorities while meeting deadlines.

Preferred

· Associate degree in Healthcare Administration, Medical Billing, or a related field.

· Certified Professional Biller (CPB) or related certification.

· Experience working in a DME supplier, home medical equipment company, or healthcare setting.

Skills and Competencies

· Attention to detail and accuracy

· Insurance verification and authorization management

· Claims processing and denial resolution

· Time management and organization

· Customer service excellence

· Data entry and record maintenance

· Knowledge of healthcare regulations and compliance standards

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Apply for DME Billing Specialist at Guardian Home Healthcare, Inc.