About the job: Nymbl Systems is an industry-leading Prosthetics and Orthotics Practice Management software suite. Job Summary: We are seeking a skilled and detail-oriented individual to join our team as an HME/DME Medical AR Specialist. You will be responsible for reviewing denied and rejected claims and ensuring compliance with relevant regulations and guidelines; correcting and properly resubmitting claims; creating appeals; sending redetermination and reconsideration requests; and responding to Additional Documentation Requests (ADRs) and Prepayment Reviews. The ideal candidate has strong analytical skills and attention to detail. This is a remote position. Responsibilities: Follow up on unpaid or denied claims and appeal when necessary; process, scrub and submit secondary/tertiary claims for HME, DME, & O&P; verify insurance coverage and eligibility; review and analyze patient records, prescriptions, and documentation; assign appropriate CPT, HCPCs, and ICD-10 codes; communicate with providers and insurers; stay updated on billing/coding regulations; maintain HIPAA compliance; collaborate with the billing team; provide training; perform other duties as assigned. Candidate Requirements: High school diploma or equivalent; certification or associate degree in billing/coding preferred; 2+ years relevant experience handling denials, appeals, resubmissions, redeterminations, ADRs, and Prepayment Reviews; experience in Orthotics or Prosthetics strongly preferred (HME/DME considered); strong knowledge of CPT, HCPCS, ICD-10; knowledge of insurance guidelines, regulations, and reimbursement policies (HME/DME/CRT/O&P); familiarity with electronic/paper claim submission and coordination of benefits; proficiency with billing software and EHR; excellent attention to detail and problem-solving; strong communication; ability to work independently; suitable work-from-home environment; knowledge of HIPAA. Candidate Preferences: Credentialing, enrollment, and accreditation experience preferred; understanding of HME, DME, and O&P terminology. Featured benefits: Medical, Vision, Dental insurance. Interested in applying? Email us at Info@NymblSystems.com. Posted on Nov 9, 2023.