DME Reimbursement Specialist

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Prochant

WebsiteLinkedInAll Job Openings

501 - 1000 employees

⚕️ Healthcare Insurance

☁️ SaaS

💳 Fintech

Healthcare Insurance • SaaS • Fintech

Prochant is a company specializing in optimizing revenue cycle management (RCM) for the home-based care sector, including home medical equipment, infusion, and home health care. They leverage innovative technology and expert teams to improve financial performance and efficiency for their clients. Prochant's services cover intake, billing, and collections with flexible partnership offerings to meet diverse operational needs. Their proprietary Prochant Pulse technology includes analytics and AI-driven workflow management for enhanced decision-making and productivity. By handling RCM processes, Prochant allows clients to focus more on patient care and operational success.

📋 Description

• Billing Review • Claim Generation • A/R & Denial Management • Unaddressed Claim Management • Stop/Held Revenue review • Correspondence review and Indexing • Reporting and reconciliation of all executable work tasks • Escalations/tasking of work exceptions to appropriate parties • Management of follow-ups • Peer support/Peer coaching • Quality Assurance • Eligibility • Prior Authorization • Intake • Cash posting • Manage inbound queue of orders to be reviewed/claims to be generated • Quality review prior to claim generation • Claim generation within specified turnaround time • Maintenance of downloads and production logs • Exception Tasking • Follow Ups • Denied claim review and analysis • Denied claim resolution action including, but not limited to: • Telephone claim status requests • Telephone re-opening requests • Medical documentation/Supporting documentation reviews • Redeterminations and appeals • Review of inbound scanned documentation • Analysis of documents and assignment to appropriate document classes (for follow up) • Eligibility or benefit verification • Prior authorization submission

🎯 Requirements

• High School diploma or GED • 2+ years DME / HME billing & collections experience • Experience managing intake, billing, collections, and cash posting • Knowledge of the HDMS billing system • Willingness to undergo additional identity verification through ID.me • Knowledge of one or more of the following additional DME / HME billing systems: Brightree, TIMS, Bonafide, or CPR+ preferred • California Insurance experience preferred

🏖️ Benefits

• Health Insurance • Gap Insurance • Dental Insurance • Vision Insurance • Short Term / Long Term Disability (company paid) • Term Life Insurance (company paid, employee can elect additional) • Full suite of CHUBB supplemental insurance plans including: • Disability Income • Level Term Life • Accident Insurance • Critical Illness Insurance • Pre-Paid Legal • FSA / HSA with eligible plans • 401K with company match • Floating holidays and paid time off