DME Billing Specialist

Job Summary

Detail-oriented and knowledgeable in DME billing, the remote DME Billing Specialist will support durable medical equipment billing across multiple pharmacy locations, ensuring accuracy and compliance while resolving claim issues and communicating effectively with various stakeholders.

Key responsibilities

• Review DME billing for accuracy, compliance, and adherence to payer guidelines
• Adjudicate claims and follow up on unpaid claims, rejections, and denials until resolved
• Utilize billing systems such as Frameworks LTC, ECM, and Medbill to process DME claims

Required qualifications

• Strong knowledge of DME billing, Medicare Part B, and Medicaid billing requirements
• Minimum of 1 year of experience in a retail or long-term care pharmacy environment; 2+ years preferred
• 1-3 years of DME billing experience required
• Proficiency with Frameworks LTC and ECM; Medbill experience preferred
• Ability to interpret payer guidelines and apply them accurately to claim review and submission