Job Description: Medical Biller
Job Overview:
The Medical Biller plays a critical role in ensuring accurate, timely, and compliant billing for Durable Medical Equipment (DME) claims. This position manages the full revenue cycle—from claim creation and submission to payment posting and denial resolution—while maintaining strict adherence to payer guidelines, documentation requirements, and audit standards. The Medical Biller supports patients, referral sources, and internal teams by ensuring claims are processed correctly the first time, reducing delays and maximizing reimbursement
Role and Responsibilities:
- Prepare and submit DME claims to Medicare, Medicaid, and commercial payers with complete and compliant documentation.
- Verify insurance coverage and obtain required authorizations, CMNs, prescriptions, and supporting clinical documentation.
- Review documentation for compliance, including proof of delivery, technician notes, and physician orders.
- Monitor claim status, follow up on unpaid or rejected claims, and resolve denials promptly.
- Post payments and adjustments accurately into the billing system.
- Communicate with payers to clarify requirements, resolve issues, and ensure timely reimbursement.
- Maintain accurate patient records, billing logs, and audit-ready documentation.
- Collaborate with intake, scheduling, and service technicians to ensure documentation completeness and accuracy.
- Identify trends in denials or delays and recommend process improvements.
- Provide excellent customer service to patients, caregivers, and referral partners regarding billing questions.
- Ensure compliance with Medicare, Medicaid, and commercial payer policies, as well as internal audit standards.
Participate in any training and educational workshops as assigned
Core Role and Responsibilities Summary
The Medical Biller ensures clean, compliant, and timely DME claim submission and reimbursement. This role safeguards revenue by verifying documentation, resolving denials, posting payments, and maintaining audit-ready records. Success in this position requires accuracy, attention to detail, strong communication skills, and a deep understanding of payer requirements for DME billing.
Key Skills and Qualifications
- 1–2 years of medical billing experience, preferably in DME, HME, or home health.
- Strong understanding of Medicare, Medicaid, and commercial payer policies.
- Experience with HCPCS, ICD-10, and CPT coding relevant to DME billing.
- Ability to read and verify clinical documentation, prescriptions, CMNs, and prior authorizations.
- Proficiency with billing software, EMR systems, and payer portals.
- Strong attention to detail and accuracy in claim creation, payment posting, and denial resolution.
- Excellent communication skills for interacting with payers, patients, and internal teams.
- Ability to manage multiple claims, deadlines, and follow-ups in a fast-paced environment.
- Solid understanding of audit requirements, documentation standards, and compliance rules.
Professional demeanor and high level of integrity
Reports to: Director of Operations
FLSA Status: Non Exempt
Schedule: Full time
Equal Opportunity / Accommodation
We are an equal opportunity employer and consider all qualified applicants without regard to legally protected characteristics. Reasonable accommodations may be made to enable individuals with disabilities to perform essential job functions.
Disclaimer
This job description is intended to outline the general nature, essential duties and qualifications required for this position. It is not designed to be an exhaustive list of all responsibilities, tasks or competencies. Responsibilities and duties may change at any time, with or without notice, to meet operational requirements and/or regulatory requirements.
Pay: $18.00 - $22.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Work Location: In person
