Claims Resolution Specialist

VieMed Healthcare; Lafayette (LA); On-site; USD 42,000 - 66,000; Full time

Job summary

VieMed Healthcare in Lafayette, LA seeks a billing specialist with 3–5 years in DME or medical billing. You will review EOBs, verify insurances, and handle back-collections tasks.

Strong communication with carriers, patients, and internal teams is essential to ensure accurate claims and patient benefits. Proficiency in Microsoft Office and attention to detail will support efficient processing of denials, documentation, and timely billing.

Qualifications

• 3–5 years in DME or medical billing preferred.
• Minimum of 1 year of insurance verification or authorizations required.

Responsibilities

• Review insurance policies and EOBs to support billing.
• Review medical documentation for claims accuracy.
• Handle back-collections tasks including denial appeals, payment review, and claims generation.
• Communicate with insurance carriers, patients/families, and internal teams for patient benefits.
• Perform clerical tasks such as answering calls, faxing, and emails.
• Report concerns to Revenue Cycle Manager and Supervisor.
• Other duties as assigned.

Skills

Superior organizational skills

Microsoft Office

Attention to detail

Professional communication (written &

Education

High School Diploma or equivalent

Tools

Microsoft Office (Outlook, Word, Excel)

Job description

Duties

• Review and understand Insurance policies and standard Explanation of Benefits.
• Review and understand medical documentation effectively
• Review and resolve Back Collections related tasks, such as
  • Denial appeals
  • Payment review and balance billing
  • Claims generation
• Establishes and maintains effective communication and good working relationships with insurance carriers, patients/family, and other internal teams for the patient’s benefit.
• Performs other clerical tasks as needed, such as
  • Answering patient/Insurance calls
  • Faxing and Emails
• Communicates appropriately and clearly to Manager/Supervisor, and other superiors. Reports all concerns or issues directly to Revenue Cycle Manager and Supervisor
• Other responsibilities and projects as assigned.

Requirements

• High School Diploma or equivalent
• Knowledge of Explanation of Benefits from insurance companies
• General knowledge of government, regulatory billing and compliance regulations/policies for Medicare & Medicaid
• Working knowledge of CPT and ICD-10 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits.
• Enough knowledge of policies and procedures to accurately answer questions from internal and external customers.
• Utilizes initiative while maintaining set levels of productivity with consistent accuracy.

Experience

• 3-5 Years in DME or medical billing experience preferred.
• Minimum of 1 year of insurance verification or authorizations required.

Skills

• Superior organizational skills.
• Proficient in Microsoft Office, including Outlook, Word, and Excel.
• Attention to detail and accuracy.
• Effective/professional communication skills (written and oral)