Adam - Reimbursement Systems Analyst at Home Medical Equipment Specialists LLC

Expertise in medical billing, claims review, coding accuracy, and reimbursement processes.

Skilled in creating and reviewing reports to monitor pricing, inventory, and financial metrics.

Proficient in maintaining inventory pricing and fee schedules across multiple insurance providers.

Effective in managing client interactions, resolving billing issues, and ensuring compliance.

Upkeep of inventory pricing over several insurance companies fee schedules, Creation and upkeep of sales order validation rules and logic, Creation and review of various reports linked to item pricing

Reviewal of medical billing claims to ensure company is properly reimbursed, Reviewing rental equipment for pickup, Re-working invoices for proper medical coding, Ensuring COB is properly applied, Contacting insurance companies for member eligibility, authorization and claims information

Keying of information (member, drug, dosage and provider) for prescription medication services

Reviewing previously incorrectly processed medical claims for inconsistencies and payment inaccuracies, Reviewing member information, medical procedures, pricing, provider information and medical coding for Medicare, Medicaid and Commercial service claims to HIPPA guidelines