Sr. DME Billing Integrity Analyst

What You Will Do

  • Assist in the monthly statement audit review for new vendors and markets, with special focus on new rentals and first-time mail-order product deliveries and shipments.
  • Conduct monthly pre-billing reviews and data quality analysis to ensure that statements delivered to our vendors are accurate. 
  • Receive, track and process vendor adjustments to ensure month end statements are correct and paid timely.
  • Compares patient billed charges to vendor statement line items and performs contractual and payor reviews to identify, analyze and mitigate billing risks. 
  • Manage and complete special billing projects to ensure deadlines are met, audits are completed successfully and for non-supported systems, which requires manual updates and oversight. 
  • Creates and develops reports to address management needs; analyzes information to identify trends or issues and recommends process improvements as appropriate. Implement changes as approved.
  • Acts as a central point of contact on vendor billing related matters for various internal departments including but not limited to Accounting, Network, Fulfilment Operations, Vendor Services and Operations.
  • Partnering with vendor ops team (vendor recruitment and implementation team) to update/maintain system of record for vendor statement information (pricing, terms, etc.).
  • Bachelor’s degree in business, Accounting, Finance, or related field.
  • At least 5 years’ in accounts payable role including 2 years’ experience in the healthcare industry with Durable Medical Equipment (DME)  operations/billing experience.  Preference will be given to candidates with experience/knowledge of HCPCS from a supplier’s perspective. 
  • Demonstrate organizational skills.
  • Demonstrate effective verbal and written communication skills.
  • Demonstrate analytical skills when problem-solving.
  • Demonstrate high attention to detail and a high degree of accuracy.
  • Support process improvement.