HME Billing Specialist

Find your WHY at Reid Health

The HME Billing Specialist position works closely under the direction of the HME Billing Lead in maintaining the integrity of the Reid Health Medical Equipment Department revenue cycle. Responsibilities will include providing excellent customer experience every time to those inquiring about payer coverage pertaining to the services HME provides and status of submitted claims. Conduct follow up calls to customers and insurance payers as necessary. Advises and instructs the HME Sales Specialist designated to billing as to the proper billing procedures for various types of medical equipment including but not limited to mobility products, diabetic shoes and supplies, compression hose, braces, bath safety, mastectomy, diabetic testing and pump supplies, ostomy, urological and wound supplies. Provides support to the HME Sales Specialist when needed to cover diabetic shoe, compression and mastectomy fittings

Let's Shine. Together.

Our values of Excellence, Empathy, Integrity and Accountability are essential to exceed our customers’ expectations. At Reid, we look for individuals who believe in our core values and demonstrate a genuine desire to make a positive impact to those we serve. We take pride in employing people who show up every day with a commitment to these values along with our mission and vision. We are one team working toward a common goal of providing outstanding customer care and service to our communities. If you have a calling to serve and are looking for meaningful and purposeful work, Reid Health is the place for you.

To lead our communities to well-being, one person at a time. It is not just what we do – it is who we are.

Overview Of Responsibilities

• Completes logs for admissions, discharges, and medical necessity for HME.
• Communicates with health information management and patient financial assistance for additional billing needs.
• Responsible for inventory management and new product data entry, for billing DME/HME services only.
• Processes incoming and outgoing e-Faxes through Reid HME billing software.
• Represents the hospital and patient by communicating with payers as required.
• Answers the phone using the appropriate HME greeting within three rings.
• Transfers calls to the appropriate HME staff member or refers to a servicing provider.
• Completes daily worklist in HME billing software.
• Attends bi-monthly meetings via Microsoft Teams or in person depending on schedule.
• Fills in on unscheduled hours/shifts when needed; may include open, closing or weekend shifts at the HME store or other off-site Reid Health offices.
• Prepares material for bi-monthly staff meetings pertaining to billing and workflows.
• Processes Prior Authorization forms, Certificates of Medical Necessity, and documentation for appropriate billing of equipment and supplies to third party payers.
• Assist with filing, shredding, and other department record keeping as necessary.
• Maintains record keeping and filing system in accordance with departmental policy. Classifies, sorts and files correspondence, records, and other documents accordingly. Purges files in accordance with policy. Retrieves information from files as requested.
• Assists in developing and implementing clerical policies and procedures for efficient department operation.
• Maintains Sales Orders and Certificates of Medical Need in billing software to keep the system clean for all department users.
• Answers patient inquiries directly or through Finance Systems pertaining to patient balances and billing processes.
• Investigates claim denials.
• Assists Billing Lead with Medicare Additional Documentation Requests or other time sensitive audits.
• Maintains individual Revenue Cycle Worklist work ques in billing software.
• Assists Billing Lead with department billing audits in regards to department quality indicators.
• Maintains professional paper claims by preparing additional documentation, printing, mailing, and monitoring open claims appropriately.
• Cash register operation and balancing, when needed for shift coverage.
• Schedules appointments for HME Sales Specialist and Manager using Microsoft Outlook.
• Greets every customer or patient that enters the HME store or HME Offices with eye contact and a warm positive tone.
• Access HME department voicemails, and log appropriately for Quality Improvement.
• Fills in on unscheduled hours/shifts when needed; may include open, closing or weekend shifts at the HME store or other off-site Reid Health offices.
• Provides instruction, consultation and fitting to patients/customers for diabetic shoes, compression garments, orthopedic braces, nursing bras and breast prosthesis products as needed when covering shifts for the HME store
• Maintains knowledge of specialized fitting services provided by Reid HME by completing annual compliance training provided by vendors or senior knowledgeable staff.
• Other duties or responsibilities deemed necessary by management.
  
  

Education/Experience

Education Required: Minimum of High School diploma or equivalent.

Experience Required:Minimum two years customer service and excellent computer skills.

Experience Preferred: Two years medical office or related experience, HME/DME product knowledge and professional billing knowledge preferred.

Certifications:Required completion of training and certification within first year of hire for Diabetic Footwear, Mastectomy Fitting, Compression Garments, Off the Shelf Orthotic Bracing, Ostomy, Urological and Surgical Wound Healing Supplies.

Schedule Details

Day Shift. 40 hrs/week - hours vary: Monday - Friday, 8am - 6pm; Possibility of some holidays or weekends depending on events.

What We Offer

Unexpected Perks - Daycare, Doordash, SmartDollar, Daily Pay, therapy dogs, massages, Forbes rated Best Places to Work 2022

Stay Connected

Not quite what you are looking for? Submit your information here for general consideration. One of our employment specialists will be in touch with next steps.

Other Information

EEO Statement: Reid Health is an Equal Opportunity Employer

No Search Firms:

Reid Health does not accept unsolicited assistance from search firms for employment opportunities. Please do not call or email. All resumes submitted by search firms to any employee or other representative at Reid Health via email, the internet or in any form and/or method without a vaild written search agreement in place and approved by HR will result in no fee being paid in the event the candidate is hired by Reid Health.

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