DME Billing and Claims Specialist

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🔥 1 minute ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

👻 Ghost score 11%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.Why this score:

• Just posted.
• Jobs at this company usually fill in 45 days.
• No salary listed.

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ACU-Serve

WebsiteLinkedInAll Job Openings

501 - 1000 employees

🏥 Healthcare

⚕️ Healthcare Insurance

💳 Fintech

Healthcare • Healthcare Insurance • Fintech

ACU-Serve is a company that specializes in optimizing revenue cycles for healthcare providers, particularly in the HME (Home Medical Equipment) and DME (Durable Medical Equipment) sectors. They focus on increasing clean claims through strategic partnerships, innovative solutions, and advanced technology. ACU-Serve's comprehensive approach includes revenue cycle management, A/R collection services, and resupply for infusion pharmacy and complex rehabilitation services, ensuring swift and accurate payments while enhancing client education and operational efficiency.

📋 Description

• Review open accounts receivable for an assigned client load and evaluate collection needs • Independently identify and resolve denials, rejections, and claims with no response • Research payer websites, manuals, government websites, and medical resources for claim requirements • Initiate collections through telephone contacts, letters, contracts, websites, and other channels • Review high-touch and Tier 2 claims and provide feedback to first-touch teams • Identify and escalate price table issues according to contract or payer guidelines • Identify, summarize, and escalate payer non-payment or delayed-payment patterns • Work with payer or provider representatives to resolve outstanding issues • Evaluate claim volume to determine efficient resolution approaches or initiate payer projects • Leverage technology to identify process inefficiencies and recommend continuous improvements that enhance revenue flow • Work to minimize write-offs by exhausting resolution options

🎯 Requirements

• Experience working with DME (Durable Medical Equipment) claims, including Complex Rehab experience • CRT • Experience working with insurance carriers to resolve or address denied or partially paid DME claims • Atlas Software experience preferred • Ability to effectively work denials received from insurance payers • Ability to review an Explanation of Benefit or Remittance Advice • Ability to utilize software efficiently by submitting claims and working payer rejections • Understanding of HCPCS and modifier combinations and diagnosis coding

🏖️ Benefits

• Equal opportunity employment commitment • Workplace free of discrimination and harassment • Diversity, inclusion, and respect promoted • Employment decisions based on qualifications, merit, and business needs

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