Position Summary: 

The Home Oxygen Insurance Billing Specialist supports Bozeman Health Home Oxygen by helping obtain maximum and appropriate reimbursement through accurate, timely, and compliant billing practices. This role works closely with the third-party biller and Home Oxygen Manager to prepare and submit durable medical equipment (DME) claims, resolve claim edits, and complete payer follow-up for unpaid, returned, or denied claims. The specialist monitors payer responses, coordinates corrected or replacement claims and appeals, and reports payer trends or systemic issues to support Revenue Cycle performance improvement.

Qualifications:

Required

• High school diploma or equivalent.
• One (1) year of general or medical office experience.

Preferred

• Medical billing certification or completion of a medical billing program (e.g., CPC, CPB, CMRS or equivalent).
• Two (2) years of healthcare billing experience, including claims submission, follow-up, and denial resolution (DME experience preferred).
• Experience billing DME/Home Oxygen and knowledge of Medicare DMEPOS billing requirements.
• Experience using Brightree or similar DME billing platform.
• Experience using Epic or other EHR/PM systems.
• Working knowledge of ICD-10-CM and HCPCS Level II coding and payer policies (Medicare/Medicaid/commercial).

Essential Job Functions:  In addition to the essential functions of the job listed below, employees must have on-time completion of all required education as assigned per DNV requirements, Bozeman Health policy, and other registry requirements.

• Submitting, auditing, and managing claims for DME, prosthetics, orthotics, and supplies to payers.
• Verifying patient insurance eligibility, obtaining prior authorizations, and confirming medical necessity.
• Following up on unpaid or denied claims, resolving discrepancies, and collecting payments.
• Ensuring all documentation meets HIPAA and payer-specific standards to avoid fraud or denials.
• Reviewing physician orders and patient care reports for accuracy.
• Reviews accounts by verifying that reimbursement amounts are appropriate, coordination of refunds, if appropriate, and submitting adjustments for approval when necessary, routes claims for appeal, resubmits claims, or moves balances from insurance responsibility to patient responsibility when appropriate.
• Provides cross-trained front desk coverage during staff absences or scheduled vacations.
• Responds directly to patient billing questions and concerns in a timely and professional manner.
• Identifies and escalates claim processing concerns to the Home Oxygen Manager.

Knowledge, Skills and Abilities

• Demonstrates sound judgment, patience, and maintains a professional demeanor at all times.
• Exercises tact, discretion, sensitivity, and maintains confidentiality.
• Performs essential job functions successfully in a busy and stressful environment.
• Learns current and new computer applications and office equipment utilized at Bozeman Health.
• Strong interpersonal, verbal, and written communication skills.
• Analyzes, organizes, and prioritizes work while meeting multiple deadlines.

Schedule Requirements

• This role requires regular and sustained attendance.
• The position may necessitate working beyond a standard 40-hour workweek, including weekends and after-hours shifts.
• On-call work may be required to respond promptly to organizational, patient, or employee needs.

Physical Requirements

• Lifting (Rarely – 30 pounds): Exerting force and/or using a negligible amount of force to lift, carry, push, pull, or otherwise move objects or people.
• Sit (Continuously): Maintaining a sitting posture for extended periods may include adjusting body position to prevent discomfort or strain.
• Stand (Occasionally): Maintaining a standing posture for extended periods may include adjusting body position to prevent discomfort or strain.
• Walk (Occasionally): Walking and moving around within the work area requires good balance and coordination.
• Climb (Rarely): Ascending or descending ladders, stairs, scaffolding, ramps, poles, and the like using feet and legs; may also use hands and arms.
• Twist/Bend/Stoop/Kneel (Occasionally): Twisting, bending, stooping, and kneeling require flexibility and a wide range of motion in the spine and joints.
• Reach Above Shoulder Level (Occasionally): Lifting, carrying, pushing, or pulling objects as necessary above the shoulder, requiring strength and stability.
• Push/Pull (Occasionally): Using the upper extremities to press or exert force against something with steady force to thrust forward, downward, or outward.
• Fine-Finger Movements (Continuously): Picking, pinching, typing, or otherwise working primarily with fingers rather than using the whole hand as in handling.
• Vision (Continuously): Close visual acuity to prepare and analyze data and figures and to read computer screens, printed materials, and handwritten materials.
• Cognitive Skills (Continuously): Learn new tasks, remember processes, maintain focus, complete tasks independently, and make timely decisions in the context of a workflow.
• Exposures (Rarely): Bloodborne pathogens, such as blood, bodily fluids, or tissues. Radiation in settings where medical imaging procedures are performed. Various chemicals and medications are used in healthcare settings. Job tasks may involve handling cleaning products, disinfectants, and other substances. Infectious diseases due to contact with patients in areas that may have contagious illnesses.

*Frequency Key: Continuously (100% - 67% of the time), Repeatedly (66% - 33% of the time), Occasionally (32% - 4% of the time), Rarely (3% - 1% of the time), Never (0%).