Medicare Payer Audit & Appeals Specialist (DMEPOS)

ABC Medical; Richardson (TX); On-site; USD 28,000 - 32,000; Full time

Benefits offered by this job

Competitive pay

Paid time off

Health insurance

Life insurance

401(k) retirement plan

Parental leave

Disability coverage

Job summary

ABC Medical is seeking a Payer Audit and Appeal Specialist to manage denial-related workflows for Medicare, Humana Medicare and commercial payer claims. You will gather medical records, respond to audits, and ensure timely submission.

The role requires 3–5 years of DMEPOS Medicare experience, strong analytical and communication skills, and familiarity with Brightree. Office location is South Pittsburg, TN with five days in the office.

Qualifications

• Analytical skills and attention to detail are required.
• Excellent verbal and written communication skills.
• 3–5 years of DMEPOS Medicare experience.

Responsibilities

• Respond to all payer audits and ensure timely and accurate submission.
• Gather and submit required documentation through the appeals process.
• Follow up on audit submissions to ensure timely responses and outcomes.
• Identify denial reasons and request documents needed to appeal claims.
• Collaborate with Referral Management to obtain supporting records.
• Maintain knowledge of Medicare appeals process and LCDs and communicate updates.
• Provide feedback to leadership for reports and process improvements.

Skills

Analytical skills

Attention to detail

Excellent verbal and written C skills

Education

High School Diploma

Bachelor's Degree

Tools

Brightree

Microsoft Excel

Job description

ABC Medical is seeking a Payer Audit and Appeal Specialist to manage denial-related workflows for Medicare, Humana Medicare and commercial payer claims. You will gather medical records, respond to audits, and ensure timely submission.

The role requires 3–5 years of DMEPOS Medicare experience, strong analytical and communication skills, and familiarity with Brightree. Office location is South Pittsburg, TN with five days in the office.