We're Hiring! Discover why our work environment was awarded as a Great Place to Work. Join our team, Apply TODAY!
We are hiring for Senior Medical Billing Specialist (experience in DME insurance billing)
What's in it for you
- Competitive Compensation
- Monthly Allowance & Perfect Attendance Bonus
- Mid-Year Bonus
- HMO Coverage & Life insurance
- Mandated Government Benefits
- 25% Night Differential
- Company provided equipment
- Great Company Culture
Work Set-up: Work From Home
Shift: 2AM-11AM, Monday Friday
Roles and Responsibilities:
The Senior Medical Billing Specialist is responsible in supporting U.S. based Durable Medical Equipment (DME) billing operations by ensuring accurate claim preparation, documentation review, and payer compliance prior to submission. The role works closely with Intake, Confirmations, and Senior Billing teams to reduce billing errors and delays.
- Reviews prescriptions, CMNs, chart notes, and signatures for completeness and accuracy.
- Validates documentation against Medicare, Medicaid, Medicare Advantage, and commercial payer requirements.
- Identifies and resolves documentation gaps prior to claim submission.
- Reviews insurance eligibility, coverage, authorizations, and benefit requirements.
- Confirms frequency limits, payer-specific rules, and authorization needs.
- Identifies and escalates payer coordination issues.
- Reviews HCPCS codes and modifier usage for DME product lines including Orthopedic Bracing, Wound Care, and CGM.
- Ensures billing accuracy aligned with payer policies and internal workflows.
- Escalates complex billing or coding issues appropriately.
- Maintains accurate order records and billing data in Brightree.
- Supports order tracking, billing preparation, and claim workflows.
- Ensures data consistency and integrity across systems.
- Communicates with payers to clarify documentation requirements or claim status.
- Supports claim follow-ups and documentation requests.
- Assists with appeals, denials, and resubmissions under senior billing guidance.
Required Qualifications:
- Minimum of five (5) years of medical billing experience.
- Minimum of three (3) years of DME insurance billing experience.
- Experience using Brightree cloud-based software.
- Has working knowledge of U.S. insurance billing processes.
- Experience supporting U.S. insurance billing (Medicare, Medicaid, Medicare Advantage, Commercial).
- Experience supporting multiple DME product lines (Orthopedic Bracing, Wound Care, CGM).
- Applies expertise in HCPCS coding, modifiers, CMNs, and medical necessity documentation.
- Experience collaborating with Intake, Confirmation, and Senior Billing teams.
- Exposure to appeals and denial management workflows.
- Maintains high accuracy, attention to detail, and documentation quality.
- Manages multiple tasks while meeting billing timelines.
- Reliable internet connection and secure remote workspace.
- Work independently in a remote setup.
- Works effectively with limited supervision.
Why choose CONNEXT
Great Company Culture, Great Place to work Certified, Great Benefits, and lots of room for growth
CONNEXT is a dedicated team of business process outsourcing experts and innovators, with experience in supporting world-class companies in Title and Escrow, Healthcare, Produce Distribution, Retail and Fashion, Design Consulting, and Finance industries.
