Position Summary / Career Interest:

The HME Billing Liaison is responsible for coordinating the day-to-day billing operations of the department and working with the external billing service utilizing a centralized medical information system. The position ensures accuracy in financial transactions and maintains compliance with organizational and industry standards. May perform a variety of billing functions including but not limited to intake tasking, requesting PAR's, document review, referral follow up, insurance verification, claim submission, payment and cash posting, collecting payments, and working denials. Enters and updates patient demographics into the computer systems, prepares HME billing to be processed, prints necessary reports, performs a variety of clerical duties needed for the operation of the billing department, and assists the department by acting as liaison between MyHealth at Home and our external billing service. The HME Billing Liaison will review documentation to ensure compliance with coverage and billing policies. May be asked to assist with retail duties such as answering phones, making outbound calls to customers, scheduling appointments, greeting and assisting customers, operating our POS (point of sale) system, and other retail store related tasks. Tasks performed will be time sensitive. This position will require a detail-oriented individual with proven research and critical thinking skills.

Responsibilities and Essential Job Functions

• Provide primary support for all billing functions, and act as liaison to outside billing company.
• Responsible for the oversight and accomplishment of day-to-day billing activities.
• Knowledge of and maintains compliance with Medicare and other payers’ rules for billing and dispensing HME products.
• Enter and confirm work orders and monitor open orders for accuracy and completion.
• Ensure necessary medical documentation is obtained prior to HME claim submission.
• Ensure completion of billing tasking to include, but not limited to the following:
  1) work to ensure continuous quality improvement of billing practices,
  2) intake tasking to include insurance verification, requesting PAR’s, document review, and referral follow-up,
  3) create, update, and print sales orders for upcoming visits,
  4) verify correct insurance(s) is pulled to sales order,
  5) verify patient expected out of pocket is accurate on sales order,
  6) tracking of consignment closet invoices and submitting monthly to appropriate facilities for bill-back/charity care,
  7) sorting and processing of incoming Insurance EOB’s and payments,
  8) upload EOBs to patient accounts in Brightree,
  9) claim submission, payment and cash posting, collecting payments, and working denials,
  10) create and post deposits in Brightree
• Communicate with outside billing company to ensure the following:
  1) open communication and process improvement,
  2) resolution of billing discrepancies or errors,
  3) patient related communications occur timely and per protocol (WIPs/Tasking/etc.),
  4) all required documentation is submitted to document review, and requests for additional documentation is entered into system timely,
  5) payments are applied to the appropriate invoices, and
  6) invoices are pulled for consignment closet bill-backs, when appropriate.
• May be asked to assist with retail duties such as:
  1) answering inbound telephone calls,
  2) making outbound calls to customers,
  3) scheduling appointments,
  4) greeting and assisting customers,
  5) operating the POS (point of sale) system, and
  6) other retail store related tasks.
• Filing completed charts and maintaining records per department protocol.
• Compiling and printing Brightree reporting, as needed.
• Cross-trained to fill in for on-site hospital/clinic liaisons whenever needed.
• Trained in Policies and Procedures, forms, and document control for HME operations.
• Responsible for adherence to applicable accreditation standards.
• Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.
• These statements are intended to describe the essential functions of the job and are not intended to be an exhaustive list of all responsibilities. Skills and duties may vary dependent upon your department or unit. Other duties may be assigned as required.

Required Education and Experience

• High School Graduate or GED.

Preferred Education and Experience

• 3 or more years Home Medical Equipment Billing

Preferred Language Skills

• Fluent English -

Knowledge Requirements

• Proficient with Microsoft applications.
• Strong problem-solving skills.
• Ability to work in a fast-paced environment with demonstrated ability to juggle and prioritize multiple, competing tasks and demands.
• Experience with Brightree Software preferred.
• Excellent personnel management and organizational management skills – including written and oral communication, relationship management, customer service, and organization
• Demonstrates continuing professional growth in knowledge and skills through education, goal setting and personal development
• Create and manage respectful and impactful relationships with internal and external stakeholders
• Demonstrate strong oral and written communication skills.
• Ability to maintain patient and compliance confidentiality.
• Ability to work in a multi-focused environment.
• Excellent analytical, critical thinking and problem solving skills.
• Ability to communicate clearly and use good judgement.
• Ability to maintain patient and compliance information in strict confidence.
• Computer skills required.
• Ability to work under stress with frequent interruptions.
• Must be self-directed with strong analytical and operational problem solving skills.
• Ability to communicate clearly and use good judgement
• Demonstrated knowledge of Medicare coding rules and regulations.
• Must be able to communicate effectively with both internal and external staff as well as external customers.
• Knowledge of medical terminology.
• Excellent interpersonal relations skills
• Must be accountable, trustworthy, show initiative, and seeking continuous improvement.
• Must be customer focused and seek to exceed customer expectations.
• Must be organized, have strong problem-solving skills, and show excellent time management skills.

We are an equal employment opportunity employer without regard to a person’s race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, ancestry, age (40 or older), disability, veteran status or genetic information.