Hybrid DME Reimbursement Specialist - Medicare & Medicaid

Medical Service Company; Toledo (OH); Hybrid; USD 55,000 - 70,000; Full time

Benefits offered by this job

Competitive Pay

Advancement Opportunities

Medical, Dental & Vision Insurance

HSA with Company Contribution

Pet Insurance

Life and AD&D Insurance

Disability Insurance

Tuition Reimbursement

EAP

Job summary

MSC, a Medical Service Company, is seeking a Reimbursement Specialist for a full-time hybrid role. The position entails timely billing and collections for Medicare, Medicaid, and commercial insurance carriers, with in-office days Tue–Thu and remote work on other days.

Responsibilities include reviewing rejected claims, following up on denials, maintaining detailed notes, and assisting internal departments with billing issues.

Qualifications

• Minimum of three years of progressive third-party payor reimbursement experience in healthcare.
• Strong knowledge of Medicare, Medicaid and commercial insurance guidelines, procedures, and rules for HME billing.
• Experience with escalating billing disputes, including appeals, reviews, and redeterminations.
• Excellent communication and customer relations skills.
• Excellent interpersonal and organizational skills (a team player).
• Brightree experience preferred; standard office/computer skills.

Responsibilities

• Review rejected claims from the clearinghouse and front-end payor edits; follow up on unprocessed claims; research denials for resubmission to maximize reimbursement.
• Maintain accurate notes on each invoice worked.
• Respond to patient inquiries by phone, email, or from other internal departments.
• Assist internal departments with billing-related issues.
• Communicate obstacles to Billing Manager that may lead to inaccurate or untimely resubmission of claims.
• Performs other duties as assigned.

Skills

Third-party payor experience

Medicare/Medicaid knowledge

Billing disputes & appeals

Communication skills

Interpersonal skills

Brightree experience

Education

High school diploma or GED

Tools

Brightree

Job description

MSC, a Medical Service Company, is seeking a Reimbursement Specialist for a full-time hybrid role. The position entails timely billing and collections for Medicare, Medicaid, and commercial insurance carriers, with in-office days Tue–Thu and remote work on other days.

Responsibilities include reviewing rejected claims, following up on denials, maintaining detailed notes, and assisting internal departments with billing issues.