Customer Service Billing Specialist I

Breg is a leader in the orthopedic industry dedicated to advancing solutions that enhance patient lives. They are seeking a Customer Service Billing Specialist I to serve as the primary point of contact for patient and customer inquiries, providing professional support and resolving concerns while managing a high call volume.

Responsibilities:

• Serve as the primary onshore point of contact for patient and customer inquiries, resolving concerns at first contact when possible while managing a high daily call volume and strict service-level expectations
• Deliver prompt, professional, and empathetic support through clear verbal and written communication, including de-escalation of sensitive or complex situations to achieve positive outcomes
• Answer and route inquiries from patients, clerical staff, insurance companies, and internal teams, escalating complex issues, payer discrepancies, denial trends, or systemic concerns as appropriate
• Apply working knowledge of medical terminology, basic anatomy, orthopedic diagnoses, and ICD-10 coding guidelines in daily claim and inquiry resolution
• Safeguard sensitive information, including PHI, while ensuring compliance with HIPAA, government healthcare regulations, SOPs, and internal workflows
• Collaborate cross-functionally with onshore and offshore teams to ensure seamless call transfers, documentation, follow-up, and continuity of service
• Prepare, review, submit, and resubmit DME and DMEPOS claims for accuracy and completeness, obtaining missing information and ensuring clean claim submission in partnership with the Health Information Management (HIM) team
• Verify correct payor selection, eligibility, benefits, and required authorizations or pre-authorizations using insurance carrier portals and internal systems
• Support compliance initiatives by functioning as the onshore resource for patient-related inquiries, enabling appropriate restriction of PHI access for offshore teams
• Manage multiple accounts, payors, and priorities simultaneously, demonstrating strong organization, adaptability, and attention to detail in a fast-paced environment
• Meet daily, weekly, and monthly productivity, quality, and scorecard expectations while contributing to team goals and service continuity, including PTO coverage when needed
• Learn and support additional billing and service functions as required to maintain operational coverage and consistency
• Responsible for behaving in a professional manner both internally and externally in relationships that positively impact the company's reputation and comply with the company's policies and practices
• Responsible for being accountable and committed to demonstrating Breg’s cultural beliefs and achieving the key results of the company
• Responsible for promoting Breg's culture within the organization using established tools such as storytelling, providing focused feedback, and recognition. The performance of the position is aligned with the culture of commitment and accountability, following the steps of: See it, Own it, Solve it, and Do it

Requirements:

• High School diploma or equivalent required
• Minimum of 1 years of recent experience in medical billing required; DMEPOS experience preferred
• Experience with a variety of payor groups preferred
• Knowledge of Current Procedural Terminology (CPT), ICD-10, and Healthcare Common Procedure Coding System (HCPCS) coding and insurance billing rules
• Computer proficient to include web browser/internet search, practice management technology, Microsoft (MS) Outlook, Word, Excel, Teams, and Power Point capabilities
• Ability to work in a fast-paced environment while remaining calm and professional
• Ability to maintain consistent, regular attendance and punctuality
• DMEPOS experience preferred
• Applicable professional certification (e.g., Medical Reimbursement Specialist, Billing and Coding) preferred