Remote Patient Monitoring RPM Specialist

We are seeking a skilled RPM Reimbursement Specialist to manage the billing and reimbursement process for Remote Patient Monitoring (RPM) services. The successful candidate will be responsible for ensuring compliance with medical coding standards submitting claims for RPM services and working closely with healthcare providers and insurance companies to facilitate accurate and timely reimbursement. Expertise in CPT coding especially related to RPM is essential.

• CPT Code Billing and Management: Accurately bill RPM services using relevant CPT codes such as 99453 99454 99457 99458 and 99091.
  • 99453: Initial device setup and patient education.
  • 99454: Ongoing supply and transmission of RPM data.
  • 99457: Interactive management and patient monitoring.
  • 99458: Additional time spent managing patient data.
  • 99091: Interpretation of transmitted physiological data.
• Claims Submission: Prepare and submit claims to Medicare Medicaid and private insurers ensuring all documentation is compliant with regulatory requirements.
• Revenue Cycle Management: Ensure RPM services are properly reimbursed in a timely manner monitor payment status and follow up on outstanding claims.
• Compliance: Stay uptodate with CMS guidelines and payer policies ensuring accurate reimbursement practices for RPM services.
• Collaboration with Healthcare Providers: Work with physicians and healthcare professionals to ensure that RPM services are properly documented ordered and billed.
• Insurance and Payer Coordination: Communicate with insurance companies to resolve billing issues and clarify coverage questions.

• Experience in Medical Billing/Coding: Strong background in CPT coding especially for RPM services.
• Knowledge of CMS Regulations: Familiarity with Medicares RPM reimbursement guidelines including specific billing requirements (e.g. 16day monitoring period).
• Experience with RPM Devices: Understanding of RPM technology and its application in managing chronic conditions.
• Attention to Detail: Ability to accurately code and submit claims manage patient billing records and track reimbursement status.
• Interpersonal Skills: Strong communication skills to collaborate with healthcare providers and payers.
• Familiarity with Reimbursement Software: Experience with billing platforms and reimbursement software.

• Certifications: Medical Billing and Coding Certification (CPC CCA etc.) preferred.
• Experience with Private Insurers: Familiarity with private insurance policies and reimbursement practices for RPM services.