DME Reimbursement Specialist

About the Role: 
The Billing – Reimbursement Specialist is responsible for managing accounts receivable, resolving unpaid or denied claims, and ensuring timely reimbursement from insurance carriers and customers. This role works closely with internal teams and third-party partners to support accurate billing processes and maintain compliance with healthcare regulations.

Key Responsibilities:

• Review aging reports and follow up on outstanding balances


• Contact insurance carriers and patients/customers regarding unpaid or denied claims


• Research and resolve billing discrepancies; submit corrected claims as needed


• Manage insurance authorizations, including submission, tracking, and follow-up


• Verify eligibility and ensure accurate claim submission and reimbursement


• Maintain accurate and timely documentation in billing systems


• Reconcile data across systems prior to invoicing to ensure accuracy


• Apply appropriate adjustments or write-offs based on payer guidelines


• Respond to inbound billing inquiries and provide customer support


• Assist with audit requests and internal billing inquiries


• Ensure compliance with HIPAA, payer guidelines, and regulatory requirements


• Collaborate with internal teams to resolve account and billing issues

Required Qualifications:

• 1–3 years of experience in accounts receivable, medical billing, or collections


• Experience in healthcare billing 


• Strong understanding of Medicare DME-specific guidelines and documentation requirements


• Experience working with insurance portals and payer systems


• Knowledge of claims lifecycle, denials management, and authorizations


• Strong attention to detail and problem-solving skills


• Ability to manage multiple priorities in a fast-paced environment


• Strong customer service and communication skills

Preferred Qualifications:

• Experience in Durable Medical Equipment (DME) billing
  


• Experience with Brightree or similar billing systems