Billing Specialist

Company Overview
Our client is the premier pharmacy partner for long-term-care communities that share their commitment and priority to patient care first. The company has transformed the conventional medication management process by being high-touch and patient-focused. Our client works tirelessly to streamline the often-disjointed communication process between the integral stakeholders in the medication ordering and administration life cycle. This is accomplished by simplifying processes, educating, and communicating frequently. The comprehensive technology solutions and breadth of pharmaceutical products and services allow our client to be nimble and creative in offering the right service to meet every unique customer need. The company understands its customers’ needs and upholds the industry’s highest standards with strict adherence to federal and state regulations.

Position Overview
Our client is seeking a meticulous and detail-oriented Billing Specialist experienced in pharmacy billing, with knowledge of Durable Medical Equipment (DME) claims processing under Medicare Part B for residents in assisted living facilities. The ideal candidate possesses extensive knowledge of Medicare guidelines, documentation compliance, claim submission, and follow-up to ensure timely reimbursement and minimal claim denials.

Location: Bardonia, NY
Reports To: Billing Department
Schedule: Onsite
Employment Type: Full-Time
Salary Range: $60,000 - $75,000 USD/Annually

Key Responsibilities

• Prepare and submit DME claims to Medicare Part B, ensuring accuracy and full compliance with regulatory requirements.
• Verify patient eligibility and insurance coverage, with attention to assisted living facility billing requirements.
• Ensure all documentation meets Medicare standards.
• Track, monitor, and proactively follow up on outstanding claims, denials, and payment discrepancies.
• Manage collections for patient and insurance accounts, including monitoring aging reports, identifying delinquent accounts, and prioritizing collection efforts.
• Review, reconcile, and resolve billing discrepancies or disputes promptly to ensure accurate patient invoices.
• Collaborate with billing and accounts receivable teams to address invoicing errors or issues impacting collections.
• Maintain accurate and organized billing records and reports for internal audits.
• Stay current on Medicare Part B policies and changes affecting DME billing.
• Communicate professionally with facility staff, patients, and families regarding billing inquiries and payment arrangements.

Physical Demands
The physical demands and work environment described here are representative of those an employee encounters while performing the essential functions of this job.
Primarily office-based with extended periods of sitting, computer usage, and phone communication. Regular handling of documentation and participation in meetings.

Qualifications

• Minimum of 1-3 years of collections experience in DME and pharmacy billing, specifically with Medicare Part B.
• Strong knowledge of HCPCS codes, insurance verification processes, and claims management/processing.
• Experience working with assisted living facilities or similar long-term care environments required.
• Proficiency with medical billing software and Electronic Health Records (EHR) systems.
• Excellent attention to detail, problem-solving, and organizational skills.
• Strong communication skills for working with patients, families, and facility staff.

Compensation
The published salary range is used as a guide to provide prospective candidates with a level of compensation that is competitive with today’s market. The salary range for this position is a good faith estimate that allows for flexibility to align with various levels of experience, education, and performance.

EEO Statement
Topaz HR is an Equal Opportunity Employer and does not discriminate on the basis of race, religion, gender, national origin, age, disability, or any other status protected by applicable law. Our client values diversity and is committed to creating an inclusive environment for all employees.

Please Note: Topaz HR is conducting this search on behalf of one of our clients. The employer's name will be disclosed during the interview process, and all hiring decisions will be made directly by the client.