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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in Durable Medical Equipment billing processes, including Prior Authorization and documentation requirements, while effectively communicating with clinicians and office staff. Proficient in using Brightree DME billing software and maintaining compliance with Medicare and Medicaid regulations.
Highest-signal resume keywords
Durable Medical Billing ExperienceBrightree DME Billing PlatformMedicare and Medicaid KnowledgeAttention to DetailProblem-Solving Skills
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Durable Medical Equipment Intake ProcessesPrior Authorization RequestsDocumentation Requirements for HCPCsMedical Necessity ReviewCMN Creation and MaintenanceInsurance VerificationData EntryMS WordMS ExcelKeyboarding Skills
Soft Skills
Effective Written CommunicationAttention to DetailResults-OrientedAbility to Work in Fast-Paced EnvironmentInterpersonal Skills
Tools & Technologies
Brightree DME Billing Software
Certifications & Qualifications
High School Diploma or GED
Industry Keywords
Prior AuthorizationCertificates of Medical NecessityMedicareMedicaidCommercial Payer RequirementsHIPAA Compliance
About the role
Key responsibilities & impact- Process orders for various durable medical equipment
- Collect, review, and request medical documentation required to support medical necessity for Prior Authorization
- Submit and maintain prior authorizations and certificates of medical necessity (CMNs)
- Request documentation supporting medical necessity and ongoing need for durable medical equipment, including oxygen and sleep therapy
- Create initial, revised, and recertification CMNs in DME billing software systems
- Review incoming CMNs and medical records for accuracy
- Review and complete stop-hold reports to resolve and release held revenue to payers
- Apply Medicare, Medicaid, and other insurance rules regarding CMNs, detailed written orders, and prior authorizations
- Communicate with clinicians and office staff to follow up on outstanding requests and explain required information
Requirements
What you’ll need- Minimum of 1 year of experience in durable medical billing requirements
- Understanding of Durable Medical Equipment intake processes, including insurance verification and Prior Authorization Requests
- Experience working in the Brightree DME billing platform
- Knowledge of Medicare, Medicaid, and commercial payer requirements for coverage of prescribed equipment
- High school diploma/GED
- Knowledge of documentation requirements for multiple HCPCs
- Strong computer skills, including MS Word and Excel
- Strong keyboarding skills
- Ability to use formal business language effectively in written communication, including spelling and punctuation
- Strong attention to detail
- Ability to work in a fast-paced, task-oriented environment
- Results-oriented self-starter with a sense of urgency and ability to complete tasks in a timely manner
- Ability to review processes and procedures and suggest improvements or solutions
- Ability to work with people with diverse personalities
- Problem-solving skills, including calmly and professionally managing crisis situations
- Ability to maintain confidential patient, financial, and company information in accordance with HIPAA guidelines
Benefits
Comp & perks- Equal opportunity employment
- Workplace free of discrimination and harassment
- Diversity, inclusion, and respect in the workplace