DME Billing Specialist — Claims & Reimbursement Pro

Guardian Home Healthcare, Inc.; Raleigh (NC); On-site; USD 42,000 - 64,000; Full time

Job summary

Guardian Home Healthcare, Inc. in Raleigh, NC seeks a detail-oriented DME Billing Specialist to manage end-to-end durable medical equipment billing. You will ensure timely claim submission, verify insurance, resolve denials, and maintain compliance with payer guidelines.

The role requires knowledge of Medicare/Medicaid, HCPCS/ICD-10/CPT coding, and proficiency with EMR/EHR systems, billing software, and Microsoft Office. Strong communication and organizational skills are essential.

Qualifications

• High school diploma or equivalent.
• 1–2 years of medical billing or DME billing experience.
• Knowledge of Medicare, Medicaid, and commercial insurance billing procedures.
• Familiarity with HCPCS, ICD-10, and CPT coding.
• Proficiency in billing software, Microsoft Office Suite, and EMR/EHR systems.

Responsibilities

• Process and submit DME claims accurately and promptly.
• Verify patient insurance eligibility, benefits, and authorization requirements.
• Review physician orders and documentation for billing compliance.
• Monitor claim status and follow up on unpaid or denied claims.
• Resolve billing discrepancies and initiate appeals when necessary.
• Post payments, adjustments, and reconcile patient accounts.
• Communicate with insurers, patients, and providers regarding billing matters.
• Maintain accurate billing records and account status.
• Ensure compliance with Medicare, Medicaid, and commercial policies.
• Assist with accounts receivable management and collections.
• Prepare and maintain reports on billing performance and reimbursement trends.

Skills

Attention to detail

Analytical skills

Organizational skills

Communication skills

Time management

Customer service

Data entry

Education

High school diploma or equivalent

Associate degree in Healthcare Administration, Medical Billing, or related field

Tools

Billing software

EMR/EHR systems

Microsoft Office

Job description

Guardian Home Healthcare, Inc. in Raleigh, NC seeks a detail-oriented DME Billing Specialist to manage end-to-end durable medical equipment billing. You will ensure timely claim submission, verify insurance, resolve denials, and maintain compliance with payer guidelines.

The role requires knowledge of Medicare/Medicaid, HCPCS/ICD-10/CPT coding, and proficiency with EMR/EHR systems, billing software, and Microsoft Office. Strong communication and organizational skills are essential.