DME Account Specialist

North Sunflower; Ruleville (MS); On-site; USD 38,000 - 60,000; Full time

Benefits offered by this job

Blue Cross Blue Shield

State Retirement

Vacation

Holidays

Sick Time

Vision

Short and Long Term Disability

Discount Employee Pharmacy Program at

Clinic Visits at no cost to full-time

Job summary

North Sunflower is seeking a DME billing specialist to maintain accurate accounts, process claims, post payments, and monitor AR in line with payer rules and organizational policies.

You will verify eligibility, review orders, prepare claims with HCPCS codes, manage denials/appeals, and ensure HIPAA-compliant documentation. This Mississippi-based role offers stability and a comprehensive benefits package.

Qualifications

• Medical billing or revenue-cycle experience.
• Knowledge of Medicare DMEPOS billing.
• Confidentiality and privacy.
• Basic reconciliation
• Equivalent combinations of education, training and experience may be considered where permitted.

Responsibilities

• Verify insurance eligibility and benefits with documentation of findings.
• Review orders, delivery evidence, and authorization before billing.
• Prepare and submit claims using HCPCS codes and payer requirements.
• Post payments, reconcile balances, handle denials/appeals and AR tracking.
• Monitor rental billing cycles and documentation expirations; escalate issues.

Skills

Medical billing

Revenue-cycle management

HIPAA compliance

Attention to detail

Education

Equivalent combinations of education, training and experience

Tools

HCPCS coding

Billing software

Job description

Job Summary

Maintain accurate DME accounts, claims, payment posting, and follow-up in accordance with payer rules and organizational policies.

Essential Duties and Responsibilities

• Verify insurance eligibility and benefits and document findings without guaranteeing payment.
• Review orders, delivery evidence, medical-necessity documentation, and applicable authorization before billing.
• Prepare and submit accurate claims using applicable HCPCS codes, modifiers, and payer requirements.
• Post payments, reconcile balances, work denials and appeals, and track accounts receivable.
• Monitor rental billing cycles, documentation expirations, and recoupment risks.
• Escalate suspected overpayments, billing errors, and compliance concerns promptly.

Compliance, Quality, and Safety

• Follow applicable Medicare DMEPOS supplier standards, HQAA accreditation requirements, payer rules, and organizational policies relevant to assigned duties.
• Protect patient information under HIPAA and organizational privacy and security policies.
• Document work accurately and contemporaneously; report complaints, incidents, suspected fraud, and safety concerns through designated channels.
• Complete assigned orientation, competency assessments, emergency preparedness, infection prevention, and ongoing training.

Minimum Qualifications

• Medical billing or revenue-cycle experience
• Knowledge of Medicare DMEPOS billing
• Confidentiality
• Basic reconciliation
• Equivalent combinations of education, training, and experience may be considered where permitted.

Performance Expectations

Performance is evaluated on accuracy, timeliness, service quality, documentation completeness, teamwork, safety, and applicable operational or financial metrics. Specific targets are set by management.

Physical and Work Requirements

Work requirements vary by assignment. Reasonable accommodation will be considered consistent with applicable law. Driving, lifting, home visits, and equipment handling apply only where essential to the position.

Great Benefits Include

• Blue Cross Blue Shield,
• State Retirement
• Vacation
• Holidays
• Sick Time
• Vision
• Short and Long Term Disability
• Discount Employee Pharmacy Program at our Pharmacy
• Clinic Visits at no cost to full-time employees

This institution is an equal-opportunity employer and provider. All candidates who are extended an offer of employment will be required to undergo an FBI and Homeland Security background check and complete a drug screen.