Medical Billing Specialist (Claims Rejections & Insurance Billing)

Rose International; Florida; On-site; USD 42,000 - 60,000; Full time

Job summary

Rose International is seeking a detail-oriented Medical Billing Specialist in Lake Mary, FL, with hands-on DME billing experience. You will manage the full billing lifecycle from verification to submission, addressing rejections and ensuring timely reimbursement.

The role emphasizes accuracy, HIPAA compliance, and professional communication with patients and payers, working onsite Monday–Friday to support internal teams and patients.

Qualifications

• Hands-on medical billing and claims processing experience.
• Resolve front-end claim rejections and resubmit corrected claims.
• Experience with Durable Medical Equipment (DME) billing.
• Understanding of insurance verification, claim documentation, reimbursement, and payment follow-up.
• Strong attention to detail, organization, and data accuracy.
• Ability to communicate professionally with patients, payers, referral sources, and colleagues.
• Understanding of HIPAA and PHI requirements.
• Ability to work onsite in Lake Mary, FL, on the specified Monday-Friday schedule.

Responsibilities

• Process billing information in compliance with HIPAA, PHI requirements, and internal policies; elevate compliance concerns to the appropriate leader.
• Verify insurance coverage, communicate patient copay responsibilities, and follow up on outstanding patient payments.
• Enter and maintain accurate patient, customer, and referral information in the billing system.
• Contact referral sources, customers, and patients to obtain missing information needed to establish or complete service records.
• Review sales orders and confirm that required documentation, including signed prescriptions, proof of delivery, and acknowledgment forms, is on file before submitting claims.
• Submit accurate and timely electronic and paper claims to applicable payers.
• Identify, investigate, correct, and resubmit front-end and back-end rejected claims.
• Track missing documentation and outstanding sales orders, resolving billing questions through final payment status.
• Post payments to the correct accounts and reconcile billing discrepancies.
• Follow up on unpaid claims and outstanding balances, generate invoices as needed, and support timely collections.
• Maintain current knowledge of applicable payer requirements, billing guidelines, and reimbursement documentation.
• Respond to customer billing inquiries, document resolutions, and provide additional operational support as assigned.

Skills

Medical billing

DME billing

Claims processing

Insurance verification

HIPAA/PHI

Attention to detail

Professional communication

On-site – Lake Mary, FL

Education

High School Diploma or Equivalent

Job description

Medical Billing Specialist

Required Education: High School Diploma or Equivalent

Required Qualifications

• Hands-on medical billing and claims processing experience.


• Experience resolving front-end claim rejections and correcting/resubmitting claims.


• Previous Durable Medical Equipment (DME) billing experience.


• Understanding of insurance verification, claim documentation, reimbursement, and payment follow-up.


• Strong attention to detail, organization, and data accuracy.


• Ability to communicate professionally with patients, payers, referral sources, and colleagues.


• Understanding of HIPAA and protected health information (PHI) requirements.


• Ability to work onsite in Lake Mary, FL, on the specified Monday-Friday schedule.

Preferred Background

• Three or more years of medical billing experience, including DME billing.


• Experience managing high-volume claim queues and resolving recurring rejection issues.


• Familiarity with DME sales orders, signed prescriptions, proof of delivery, and payer-specific documentation requirements.


• Experience with cash posting, copay collection, and account reconciliation.

Position Overview

We are seeking a detail-oriented Medical Billing Specialist with hands-on experience in Durable Medical Equipment (DME) billing and front-end claim rejection resolution. This position supports the full billing lifecycle, from insurance verification and documentation review to claim submission, rejection correction, payment posting, and follow-up. The ideal candidate understands how to identify and correct claim issues before they delay reimbursement, maintain accurate patient and order records, and coordinate effectively with insurance companies, referral sources, patients, and internal teams.

Key Responsibilities

• Process billing information in accordance with HIPAA, PHI requirements, and internal compliance policies; elevate compliance concerns to the appropriate leader.


• Verify insurance coverage, communicate patient copay responsibilities, and follow up on outstanding patient payments.


• Enter and maintain accurate patient, customer, and referral information in the billing system.


• Contact referral sources, customers, and patients to obtain missing information needed to establish or complete service records.


• Review sales orders and confirm that required documentation, including signed prescriptions, proof of delivery, and acknowledgment forms, is on file before submitting claims.


• Submit accurate and timely electronic and paper claims to applicable payers.


• Identify, investigate, correct, and resubmit front-end and back-end rejected claims.


• Track missing documentation and outstanding sales orders, resolving billing questions through final payment status.


• Post payments to the correct accounts and reconcile billing discrepancies.


• Follow up on unpaid claims and outstanding balances, generate invoices as needed, and support timely collections.


• Maintain current knowledge of applicable payer requirements, billing guidelines, and reimbursement documentation.


• Respond to customer billing inquiries, document resolutions, and provide additional operational support as assigned.

Only those lawfully authorized to work in the designated country associated with the position will be considered.

Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client's business needs and requirements.