Insurance & Client Services Specialist

Position Summary

Doctors Equipment Service is seeking a detail-oriented and customer-focused Insurance & Client Services Specialist to support our Durable Medical Equipment (DME) operations. This is a hybrid role responsible for managing insurance processes while also supporting front-office functions, including customer service, retail sales, and general office operations.

The ideal candidate is comfortable balancing administrative accuracy with direct client interaction in a fast-paced environment.

Key Responsibilities

Insurance Verification & Authorizations

• Verify client eligibility, benefits, and coverage across Medicare, Medicaid, and commercial payers
• Obtain and track prior authorizations for DME products
• Ensure all required documentation (SWOs, chart notes, F2F) meets payer guidelines
• Communicate insurance coverage and client financial responsibility clearly to clients and referral sources

Billing & Revenue Cycle

• Prepare and submit accurate insurance claims using appropriate HCPCS codes and modifiers
• Monitor claim status and follow up on unpaid or denied claims
• Resolve claim issues, rejections, and denials in a timely manner
• Post payments, adjustments, and maintain accurate account records
• Ensure compliance with all payer and regulatory requirements

Client Services & Front Office Support

• Answer incoming phone calls and assist clients, caregivers, and referral sources
• Provide excellent in-person customer service within the retail/store environment
• Assist clients with product selection, basic equipment education, and point-of-sale transactions
• Address questions related to billing, insurance, and equipment

Sales & Office Operations

• Support in-store retail sales of DME products and supplies
• Process cash/card transactions and maintain accurate sales records
• Perform general office duties including data entry, filing, and order tracking
• Maintain a clean, organized, and professional front office and showroom environment

Team & Process Support

• Collaborate with intake, billing, and operations teams to ensure smooth workflow
• Identify opportunities to improve efficiency and reduce delays
• Stay up to date on payer policies, product knowledge, and company procedures

Qualifications

• 2 years of experience in DME, medical billing, insurance verification, or healthcare office setting
• Strong understanding of insurance processes (Medicare, Medicaid, commercial)
• Experience with billing, claims follow-up, and/or prior authorizations preferred
• Customer service or retail experience strongly preferred
• Comfortable answering phones and interacting with clients in person
• Basic knowledge of HCPCS coding and DME billing is a plus
• Strong attention to detail, organization, and multitasking ability
• Proficiency with EMR systems, billing software, and Microsoft Office

Preferred Experience

• Background in DME (sleep therapy, mobility, orthotics, etc.)
• Experience in a hybrid clinical retail environment
• Familiarity with documentation requirements (SWOs, CMNs, F2F notes)

Key Performance Indicators (KPIs)

• Clean claim rate / first-pass approval rate
• Authorization turnaround time
• Client satisfaction / service quality
• Sales support performance (in-store conversions, accuracy)
• Days in Accounts Receivable (AR)