Medical Billing (Complex Rehab / DME Claims)
il y a 6 jours
Sherwood
Job DescriptionDescription: Full-Time – Monday to Friday, 8:00 AM–5:00 PM Location: Tulsa, OK Pay: $20-$23 per hour About Us Action Seating & Mobility is a leading Complex Rehabilitation Technology (CRT) provider. We support individuals with significant mobility needs and work closely with clinicians, therapists, and insurers to ensure timely access to medically necessary equipment. Our Billing & AR team plays a crucial role in maintaining financial accuracy and making sure patients receive what they need without unnecessary delays. Position Overview We are seeking a Medical Billing & AR Specialist who can manage the full billing and reimbursement life cycle, including pre-billing authorization review, claim submission, payer portal follow-up, denial research, appeals, and identifying underpayment trends. This is a critical-thinking, problem-solving role, not data entry, not “just claim submission.” If you are confident navigating payer rules, interpreting EOBs, and knowing where to look when something doesn’t add up, this is for you. Requirements: What You’ll Do • Review prior authorizations and documentation to ensure billing accuracy before claim submission., • Submit clean claims and verify payer receipt via portals and clearinghouses., • Follow up on unpaid, pending, or denied claims through payer portals and direct phone outreach., • Prepare and submit appeals with supporting clinical/authorization documentation., • Interpret EOBs/ERAs to understand payment variances, contractual adjustments, and denial rationales., • Monitor payer policy changes including CMS LCD guidance and commercial payer criteria., • Track denial trends and underpayment patterns and report findings to management., • Document all claim activity thoroughly in billing system and case notes.Required Experience & Skills, • 2–4 years of medical claims billing, AR follow-up, or healthcare reimbursement experience., • Strong working knowledge of:, • HCPCS levels II, modifiers, and diagnosis linkage, • Claim forms (CMS-1500) and payer submission rules, • Medicare, Medicaid, Medicare Advantage, HMO, PPO, and Commercial payer workflows, • Experience using payer portals (Medicare, Medicaid, Tricare, Commercial) to check status/submit corrections., • Proven ability to write effective appeal letters., • Strong analytical thinking and independent problem-solving skills., • Ability to manage multiple cases and timelines without constant supervision.Preferred (Not Required), • Experience billing complex rehab seating, power mobility, or related DME., • Familiarity with TIMS, Brightree, Athena, or similar billing platforms., • Prior success working in a productivity-based billing environment.Work Environment, • Local applicants: on-site required., • Remote applicants: must have prior successful remote DME/CRT billing experience, demonstrated via interview case test., • 1st Interview: HR, • Skills Evaluation, • 2nd Interview: Billing Leadership/working interview