Dedicated to serving northeast Oklahoma's bone, joint, and muscle needs, our specialty-trained doctors at Advanced Orthopedics of Oklahoma deliver the expert, compassionate care needed to heal, recover, and advance. We proudly offer the highest level of comprehensive care for a variety of musculoskeletal concerns, from chronic pain to acute injuries, to area residents throughout Tulsa, Claremore, Bixby, McAlester, and the surrounding areas.

Job Summary:

Responsible for the complete billing, accounts receivable, and collections process for Durable Medical Equipment (DME) services. Ensures accurate and timely claim submission, follows payer requirements, resolves denials and billing issues, and maximizes reimbursement while maintaining compliance with Medicare, Medicaid, commercial payer, and applicable DME billing regulations.

Essential Functions and Responsibilities:

Submit and manage DME claims to Medicare, Medicaid, commercial insurance, and other third-party payers. Verify patient eligibility, benefits, authorizations, and required documentation prior to billing. Ensure claims contain accurate HCPCS codes, modifiers, diagnosis codes, units, pricing, and required supporting documentation. Monitor accounts receivable and aggressively follow up on unpaid, underpaid, and denied claims. Research and resolve claim denials, including medical necessity, authorization, eligibility, coding, documentation, timely filing, and coordination-of-benefits issues. File corrected claims, reconsiderations, appeals, and payer disputes as appropriate. Maintain detailed documentation of collection efforts and payer correspondence. Review EOBs/ERAs and accurately post payments, adjustments, and denials. Identify recurring denial trends and work with clinical, coding, authorization, and operational teams to prevent future denials. Follow up on outstanding balances according to established aging and collection priorities. Work payer portals, clearinghouses, and telephone systems to obtain claim status and resolve reimbursement issues. Maintain compliance with payer contracts, Medicare/Medicaid requirements, HIPAA, and DME billing regulations. Prepare and monitor AR reports, denial reports, aging reports, and collection metrics. Escalate unresolved payer issues and significant outstanding balances to management. Support continuous improvement of DME revenue-cycle processes. Schedule/re-schedule work comp patient appointments. Performs other duties as assigned.

Education:

High school diploma or GED required.

Work Experience:

One year of insurance and collection experience in a health care organization. Experience with DME billing, medical billing, accounts receivable, and collections. Licensure, Registration and/or

Certification:

None.

Knowledge, Skills, and Abilities:

Knowledge of Medicare, Medicaid, and commercial payer requirements. Knowledge of medical billing and collection practices. Understanding of HCPCS coding, modifiers, medical necessity, authorizations, and documentation requirements. Strong knowledge of claim denial and appeal processes. Excellent attention to detail and organizational skills. Strong payer follow-up, communication, and problem-solving skills. Experience with billing software, clearinghouses, payer portals, and electronic remittance systems. Ability to manage a high-volume AR workload and meet collection goals. Knowledge of grammar, spelling, and punctuation. Experience with computer, fax, calculator, and copier. Ability to read, understand and follow oral and written instructions. Ability to communicate professionally, clearly, and courteously with patients, co-workers, and others. Ability to establish and maintain effective working relationships with physicians, staff, and the public. Ability to sort and organize materials. Ability to write legibly.

Working Conditions:

Work is performed in a medical office setting. May be exposed to communicable diseases, toxic substances, ionizing radiation, medical preparations, biohazards, bodily fluids and other conditions common to a clinic setting. Involves frequent contact with staff and the public. Contact involves dealing with sick persons. Interaction with others may be constant and interruptive. Work may be stressful at times. May involve dealing with angry or upset individuals. May periodically work outside of normal work hours.

Physical Requirements:

Requires sitting for long periods of time. Requires viewing computer screen and typing for long periods. Requires normal physical strength to exert up to 30 pounds of force occasionally and/or up to 10 pounds of force frequently to move objects. Requires normal physical agility, which includes stooping, bending and stretching to access files and supplies. Requires normal concentration regarding complexity and timeliness of decision making. Requires normal memory, taking into consideration the amount and type of information involved. Average visual acuity necessary to prepare or review documents or operate equipment. Ability to speak, frequently conveying detailed or important information or ideas accurately. Ability to hear normal speech, both in person and on the telephone.

Job Type:

Full-time Benefits:

401(k) 401(k) matching Dental insurance Employee assistance program Flexible schedule Flexible spending account Health insurance Health savings account Life insurance Paid time off Referral program Vision insurance Application Question(s): What is your salary expectation? Do you have experience appealing denied medical claims?

Experience:

DME billing, medical billing, A/R and collections: 1 year (Preferred)

Work Location:

In person