Billing Specialist ; HYBRID

About Our Company

Advanced Diabetes Supply® was founded on the bold principle of creating a knowledgeable, reliable, and demonstrably superior diabetes supply company. Our approach, coupled with a commitment to service and innovation, has catapulted Advanced Diabetes Supply® to a national leader in the industry. Creating high‑performance, adaptive teams requires a relentless commitment to hiring the best. We strive to maintain a casual, fun environment whenever possible, but we don't just play around.

We work hard every day to provide a positive work culture and respectful atmosphere. The standards we set for ourselves are high, and we love to be challenged! If you enjoy working in a collaborative environment and have a passion for excellence and a bias for action, we may be just what you've been looking for.

Visit us at  to learn more about our company and its culture.

Schedule:

8:00 A.M. to 4:30 P.M. EST, Monday through Friday, with one Saturday each month from 9:00 A.M. to 1:00 P.M. EST

Location:

Hybrid in Doral, FL, with the first 90 days fully onsite.

The Billing Specialist is responsible for obtaining pre‑certification and pre‑authorizations for DME procedure codes by completing the authorization process with commercial payers. The Billing Specialist will work within the scope of responsibilities as dictated by Insurance & Billing leadership teams.

• Initiates prior authorization submissions and completes all follow‑ups for all insurance payors including Medicare Advantage, Medicaid, HMO, PPO, and Commercial until the case has reached a determination.
• Compiles pre‑certification information to submit prior authorization requests via outbound phone calls and/or web‑based sites (familiarity with payors).
• Performs regular follow‑up calls with insurance companies to check status of prior authorization requests. Logs approval in database.
• Conducts outbound and/or inbound calls to patients, doctors’ offices, and insurance companies as necessary or required to complete tasks.
• Ensures proper documentation is received and recorded before processing additional supplies to patients, per compliance guidelines.
• Ensures accurate entry and update of changes as requested by physicians and/or patients.
• Maintains working knowledge of billing guidelines and resources for Medicare and private insurances.
• Recognizes and reviews billed orders to effectively request authorization for upcoming refills.
• Researches, follows up, and resolves all open/pending authorizations in a timely manner.
• Develops and maintains knowledge of all products and services offered by the company.
• Complies with HIPAA rules, appropriately safeguarding PHI or other private and confidential information.
• Maintains accurate and detailed notes in the company system.
• Adapts quickly to frequent process changes and improvements.
• Is reliable, engaged, and provides feedback to improve processes and policies.
• Attends all department, team, and company meetings as required.
• Appropriately routes incoming calls when necessary.
• Meets patient service quality standards.
• Embraces and exemplifies ADS core values: we grow together, we care, we obsess over the customer experience, we commit, and we WOW!
• May perform any additional responsibilities or special projects as required.

• High school diploma or equivalent.
• Knowledge of insurance verification and/or authorization, billing, and processing claims.
• Basic knowledge of billing guidelines and resources for Medicare and private insurance.
• Basic knowledge of insurance portals; familiarity with a variety of medical and/or insurance terms or practices.
• Proficiency in basic math and business calculations.
• Working knowledge of computer/data entry with the ability to learn new systems.
• Basic level of MS Office proficiency.

• Friendly, professional, and effective communication skills; able to calmly present solutions in challenging situations.
• Ability to work well in a team environment that promotes inclusiveness and communication among team members.
• Effective interpersonal skills.
• Clear diction and knowledge of the English language, both written and verbal.
• Detail…