Software Optimization Specialist

ACU-Serve delivers billing solutions to HME (Home Medical Equipment) providers, giving them the freedom to grow their business while collecting more, faster. ACU-Serve has helped HME businesses cut through the complexity of an ever-transitioning billing process while becoming a trusted partner for continued growth. Clients routinely show faster collections, higher revenue and dramatically reduced management and staffing problems. ACU-Serve incorporates HME workflow, Medicare, Medicaid and Private Payer knowledge, and billing and collections experts into a single service on an Internet-based technology platform. The result is faster payments, higher revenue collection rates, and less management and staffing headaches. Unlike traditional billing service models, ACU-Serve provides HME clients with a new level of control, flexibility, information access, and billing expertise. ACU-Serve functions as an integral part of the HME office staff, not a remote third party billing vendor.

Position Summary:

The Software Optimization Specialist is responsible for Development and Maintenance of pricing databases and systems, analyzing pricing, HCPCS Coding, Modifiers, Maintenance of contract allowable’ s in databases, creating standard operating procedures (SOP), Review of metrics and completion of work to evaluate the performance of the team. Software Optimization Specialist develops pricing strategies that align with market dynamics and business objectives, driving revenue growth and profitability. The Software Optimization Specialist expertise in pricing analysis and optimization supports cliental and revenue maximization.

Duties & Responsibilities:

• Maintain a working knowledge of clients DME/HME products, modifiers, item pricing, HCPCS codes, contract allowable/fee schedules as well as billing and reimbursement guidelines including Medicare, Medicaid, third party and contracted payers.
• Communicate with Senior Client Success Managers, Client Success Managers and clientele on updates required in databases and root cause issues for corrective action.
• Create and manage standard operating procedures (SOP), as well as implement and communicate revisions and changes as needed.
• Analyze and assess processes through Key Performance Indicators and Metrics

Price Table Metrics are to be reviewed within 7-10 business days.

• Evaluate systems and processes to find improvements that will support future growth.
• Promote a supportive environment in which employees are encouraged to solve problems and issues.
• Updating insurance Settings and/or database settings to submit claims with appropriate data as required.
• Maintain confidentiality of patient health information and adhere to HIPAA guidelines.
• Lead by example, conduct self in a manner reflecting credit on the company, and actively promote and foster relationships.
• Adapt to shifting priorities and meet numerous project deadlines while retaining accuracy and attention to detail.
• Managing Multiple Priorities – Knowledge of effective self-management practices and ability to manage multiple concurrent objectives, projects, groups, or activities, making effective judgements as to the prioritizing and time allocation.
• Performs other duties as assigned.

Qualifications & Experience:

• High School diploma or GED
• Must possess an in-depth knowledge of the DME/HME industry, including coding and modifiers.
• Proficient computer skills, Microsoft Office Suite (Word, PowerPoint, Outlook and Excel).
• Ability to perform with a high degree of independent judgement, discretion, and confidentiality; and make complex decisions within a short period of time.
• Problem solving skills.
• Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
• Demonstrate the ability to communicate, present and influence leadership at all levels.
• Critical thinker who can analyze situations and make decisions that support company goals.
• Strong motivational and listening skills.
• Strong written and verbal communication skills.
• Organized and able to create multiple timelines and schedules.
• Able to multi-task, prioritize and manage time efficiently.
• Able to analyze feedback and strategize for better solutions.
• Knowledge of appropriate modifiers used when billing Complex Rehabilitative Technology Equipment preferred but not required.
• Knowledge of appropriate modifiers used when billing Durable Medical Equipment preferred but not required.

ACU-Serve is an equal opportunity employer and is committed to providing a workplace that is free of discrimination of all types and promotes diversity, inclusion, and respect. We prohibit discrimination and harassment of any kind based on race, color, sex, gender, religion, creed, sexual orientation, national origin, age, disability, genetic information, pregnancy, veteran status, or any other protected characteristic as outlined by federal, state, or local laws. This policy applies to all employment practices within our organization. ACU-Serve makes hiring decisions based solely on qualifications, merit, and business needs at the time.