DME Medical Billing Specialist

About the Role

XRHealth is seeking an experienced and detail-oriented DME Medical Billing Specialist to join our team on-site at our Needham, MA office
. In this role, you will manage all aspects of billing and reimbursement for our Durable Medical Equipment (DME) operations. You will be responsible for ensuring accurate and timely claim submissions, payment posting, and resolution of denials, while maintaining compliance with all payer and regulatory requirements. Hands-on experience with the Niko Health system is highly preferred.

• Prepare, review, and submit clean claims to insurance companies through Niko Health and other billing systems.
• Verify patient insurance coverage and eligibility for DME services.
• Process payments, adjustments, and denials accurately and efficiently.
• Investigate and resolve claim rejections or underpayments in a timely manner.
• Maintain accurate billing records and ensure compliance with HIPAA and payer regulations.
• Communicate effectively with patients, insurance representatives, and internal departments.
• Generate reports on billing performance, aging claims, and reimbursement trends.
• Stay up to date on current DME billing codes, payer guidelines, and industry regulations.

• Minimum of 2 years of DME billing experience required.
• Proficiency with Niko Health or similar DME billing software required.
• Strong knowledge of CPT/HCPCS codes, EOBs, and payer-specific requirements.
• Excellent attention to detail, accuracy, and problem-solving skills.
• Effective communication and organizational abilities.
• Ability to work independently and collaboratively in a fast-paced environment.