Intake and Medical Billing Specialist - Madison, WI

We are an exciting, fast growing and innovative medical products company revolutionizing the distribution of medical products and services. Our vision is to use technology and efficiency to improve access and affordability of Durable Medical Equipment (“DME”) products for both the end users and to business customers while reducing the cost of healthcare for payors, providers and consumers.

Come position yourself with an innovative industry leader in a fast-growing company with significant earning potential and excellent growth prospects in the future.

Job Type:

Full-time (Can be office or Remote Position). After initial training of 5 weeks the person can work from home if desired 80% of the week.


Job Summary

The Order Intake and Billing Specialist, a key position in the Revenue Cycle management on our medical insurance claim platform, manages and assists the patients through the claims process, follow-up and correspondence with insurance inquiries/correspondence. The online marketplace generates several incoming chats, phone calls and inquiries related to insurance claims, in addition enquiries generated from the field that need to be processed by providing excellent support and the right product solutions to help the patients with their medical products and mobility needs.

The incumbent will coordinate the process of patient eligibility through our third-party sources, help with product selection and coordinate from referral sources, data entry and collection process from patients and payers.


Key Responsibilities

Intake:

  • Manage the inbound online inquiries, phone calls, online chats by providing the required support and product solutions to the patients.

  • Incoming referrals from field reps, process the orders and pass it for billing to our third-party billing platform.

  • Manage incoming fax and phone calls from doctor’s office related to prescriptions and medical necessity forms.

  • Handles patient inquiries and answers questions from referral clinics and insurance companies

Billing and Claims:

  • Prepares and submits clean claims to third party medical billing company

  • Maintains relationship with billing software company, including appropriate follow-up with support issues.

  • Coordinate the process of patient eligibility through various third-party sources.

  • Coordinate with strategic partners on the backdoor and front door patient insurance out of network claims.

Collections:

  • Coordinate collection process and tracking current collections in the ERP system and with accounts team.

  • Ensure appropriate collection of co-pays, spend down and self-pay fees.

  • Handles patient inquiries and answers questions from clerical staff of insurance companies.

  • Identifies and resolves patient billing problems. o Denial and insurance follow-up management.

  • Issues adjusted, corrected, and/or rebilled claims to third party payers.

  • Posts adjustments, transfer of responsibility and refunds, as necessary.

  • Assure coding is compliant and up to date.

  • Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.


Requirements

  • Associate’s Degree or equivalent of experience and education

  • Inbound customer support experience with especially good phone communication skills.

  • Must have at least 3 years medical billing experience and collection practices including knowledge of billing related reporting;

  • Experience working with medical payers including Medicare, Medicaid eligibility system, and commercial insurance.

  • Working knowledge of CPT and ICD-9 & ICD-10 coding systems; Coding certification preferred

  • Strong keyboard skills.

  • Works well in environment with firm deadlines; results oriented.

  • Perform multiple tasks effectively.

  • Able to work both independently and as part of a team.

  • Strong analytical skills required.

  • Excellent organizational skills, and

  • Proficiency in Microsoft Office Suite

  • Physical and Cognitive Requirements: Requires full range of body motion including manual finger dexterity and eye-hand coordination.


Salary:

Base of $38K-$40K + Quarterly Bonuses

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