Responsibilities

• Submit accurate and timely claims (electronic and paper) to Medicare, Medicaid, and commercial insurance payers using billing systems (e.g., Niko Health, Salesforce)
• Monitor claims lifecycle to ensure proper adjudication and reimbursement
• Review, analyze, and post EOBs, payments, and denials across billing systems
• Investigate root causes of denials or rejections and support prevention strategies
• Escalate or route uncollectible balances to appropriate queues (e.g., write-offs, patient responsibility review)
• Communicate effectively with patients, providers, and internal teams regarding billing inquiries
• Identify workflow inefficiencies and recommend process improvements
• Support additional projects and tasks as assigned
• Maintain consistent attendance and meet productivity and quality KPIs
• Ensure compliance with HIPAA, payer requirements, and all applicable policies and regulations

Minimum Qualifications

Education & Experience

• High school diploma or equivalent required
• Some college coursework and/or medical billing certification preferred
• Minimum 2 years of experience working with Medicare, Medicaid, and/or commercial insurance
• Experience in HME (Home Medical Equipment) billing strongly preferred
• Proficiency with Microsoft Office; Salesforce experience preferred
• Equivalent combination of education, training, and experience will be considered

Skills & Competencies

• Strong knowledge of Medicare, Medicaid, and commercial insurance billing requirements (DME/HME preferred)
• High attention to detail and accuracy
• Ability to manage priorities in a fast-paced environment
• Strong analytical and problem-solving skills
• Effective written and verbal communication skills
• Ability to collaborate and work across teams
• Solution-oriented mindset with a focus on continuous improvement
• Strong organizational and time management skills
• Demonstrated work ethic and accountability