Reliable Respiratory · 2 weeks ago
Billing Claims Specialist
Boston, MA, US
Full-time
Onsite
Entry, Mid Level
2+ years expReliable Respiratory is a Durable Medical Equipment (DME) company that provides high-quality service for patients in need of respiratory and other medical support. The Billing Claims Specialist is responsible for managing claims and authorizations to ensure reimbursement, correcting claim denials, and improving claim health through analysis and reporting.
MedicalMedical Device
No H1B
Responsibilities
Review claims for denied procedures, identify issues, and take appropriate action to correct issue, resubmit claim, and procure maximum reimbursement for specific service. Duties include obtaining authorization, collecting medical documentation directly from facilities, and working with payers and provider services
Organize and report back denial trends to Management to implement measures to improve claim health and reduce payer AR times. Create and/or update written material and documentation related to insurance procedures and programs (i.e., insurance guidelines and processes and procedures)
Assist in reviewing and analyzing relevant organizational and payer data (i.e., reviews payments and denials of insurance and communicates when changes need to be made for payment and profit margins)
Develop and implement a system for working denials, ranging from dollar value to payor specialization, to age of invoice
Issue invoices and bills and send them to customers through various channels (mail, e-mail etc.)
Receive payments through various methods (cash, online payments etc.) and check for credibility
Answer questions and handle complaints from customers and payors regarding claims
Reconcile deposits and invoices posted
Qualification
Required
18 years of age or older
Must be eligible to work in the United States and not require work authorization from us now or in the future
Bachelor's Degree required
At least 2 years of medical billing, coding, reimbursement or health insurance experience preferred
Strong health insurance knowledge of New England payers and Massachusetts ACO plans
Proficient in obtaining authorizations in the most efficient manner (portal, fax form, phone in submission)
Ability to learn Billing functions and be adaptable to the needs of the position
Strong interdepartmental communication
Effective and professional verbal and written communication abilities
Professional computer experience (especially Microsoft Office Suite)
Ability to investigate problems and make decisions independently
Strong analytical skills
Company
Reliable Respiratory
Reliable Respiratory operates as a home respiratory and specialty medical equipment providers.
201-500 employees
Funding
Current Stage
Growth StageCompany data provided by crunchbase