Apply on Employer Site

Babylist · 1 day ago

Insurance Billing Specialist

United States

Full-time

Remote

Mid Level

$65K/yr - $78K/yr

3+ years exp

Babylist is the leading registry, e-commerce, and content platform for growing families, and they are seeking an Insurance Billing Specialist to help families access necessary medical equipment through accurate billing workflows. This role involves managing the DME billing cycle, including insurance eligibility verification, claims submission, and appeals, while working remotely across the United States.

BabyE-CommerceHealth CareInternetMarketplaceParentingToys

Growth Opportunities

Hiring Manager

Kevin Kane

Responsibilities

Conduct timely and accurate eligibility checks and benefit investigations through payer portals and phone outreach to ensure claims are submitted correctly from the start

Enter and monitor DME claims across multiple platforms, troubleshoot billing issues, and proactively follow up to reduce denials and accelerate reimbursement

Analyze explanation of benefits (EOBs) for errors, missing payments, or misapplied patient responsibility, then determine and execute the correct resolution path

Write detailed, well-supported appeals that address denial reasons clearly and improve chances of successful claim recovery

Work aging reports weekly to identify unpaid or incorrectly paid claims, collaborate with payers or escalate internally as needed to drive resolution

Provide clear and empathetic responses to patients with billing questions, helping them understand their benefits and out-of-pocket costs without confusion

Work with Billing teammates, Customer Experience, Fulfillment, and cross-functional partners to identify process gaps and improve billing operations end to end

Use AI-enabled tools that assist with eligibility, claims validation, and documentation to improve efficiency while maintaining billing accuracy and compliance

Ensure timely access to medically necessary DME by reducing billing friction, shortening reimbursement cycles, and ensuring every claim is processed with care

Qualification

DME Billing ExperienceEOB InterpretationBrightreeNikoHealthCompliance KnowledgeAI ReadinessAttention to DetailCommunication Style

Required

3+ years of direct experience in DME billing and insurance reimbursement, managing the full claim lifecycle from eligibility verification through appeals and collections

Confidently review EOBs, identify payment discrepancies, denials, and adjustments, and take appropriate follow-up actions with minimal oversight

Worked extensively in Brightree and NikoHealth or comparable billing platforms, and are comfortable navigating EMRs like Epic, Kareo, or AdvancedMD to document and track claim progress

A working understanding of CPT, HCPCS, ICD-10, and relevant DME billing regulations such as HIPAA, CMS, and ERISA, and apply them accurately in your daily work

Spot issues others miss, ensuring claims are submitted cleanly, documentation is complete, and no step in the process is overlooked—even at high volume

Explain complex billing issues clearly and professionally, whether you're resolving a patient inquiry, collaborating with internal teams, or working with payers to resolve a denial

Thrive in a contributor role that values mastery, precision, and process excellence. You take pride in doing important behind-the-scenes work that has a direct impact on patient access and company success

Open to using AI tools that improve workflow efficiency and accuracy, and willing to adapt as the team adopts new technologies that enhance billing operations