Do you have a passion for patient advocacy? Is your calling in healthcare greater than what you are doing today? If you want to have an impact, then we want to talk to you about joining our team.
Our organization bridges the gap between clinical providers and chronic wound patients looking for a dependable supply partner for wound care products that can be used at home. We are one of the best in the industry at offering innovative solutions to the challenges of balancing supply costs while ensuring continuity of care, increasing compliance and patient satisfaction.
We are seeking a compassionate and patient focused individual to join our Service Operations team! NO weekends, NO call and off major holidays! You will be responsible for being a patient advocate as we help patients navigate the many challenges they face on their journey towards healing. You will be on the front lines of supporting customers by helping navigate Medicare, Medicaid and Commercial payor benefits and medical necessity requirements to successfully ship and bill for wound supply orders for patients in need.
Direct Medical Incorporated is dedicated to your success! Our core values are 1) Always putting the Patient First, 2) Being a Solutions Provider in all that we do, 3) Highly responsive in all communication and engagements. We are committed to ensuring our employees receive proper training in order to provide excellent service to all our customers and living our core values.
Duties:
* Follow up on claims that have been denied.
* Create and follow commercial insurance appeals from beginning to end.
* Follow up on claims that are not paid within 30 days from bill date.
* Ensures legal compliance by following company policies, procedures, guidelines, as well as state and federal insurance regulations.
* Obtain any information requested by insurance companies as it pertains to claims payment and submission.
* Prepares reports by collecting, analyzing, and summarizing information.
* Stay current on insurance guidelines, regulations, and fee schedules.
* Accomplishes organization goals by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments.
Skills/Qualifications:
Busy medical office experience, insurance collections experience, Medicare billing, Medicare appeals, able to work autonomously and as a team, DME billing a plus.
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