Position Summary:

The DME Biller is responsible for the accurate and timely billing of Durable Medical Equipment (DME) claims to Medicare, Medicaid, commercial insurance carriers, and other third-party payers. This role ensures compliance with payer regulations, manages claim follow-up, resolves billing issues, and supports revenue cycle optimization by minimizing denials and maximizing reimbursement.

Schedule:

• Mondays to Fridays, 9:00 am to 6:00 pm (US Eastern Time), with a 1-hour unpaid break (40 hours per week)

Key Responsibilities:

• Prepare, review, and submit clean electronic and paper claims for Durable Medical Equipment (DME) services.
• Verify patient insurance eligibility, benefits, prior authorizations, and coverage requirements.
• Ensure documentation supports medical necessity and complies with payer and regulatory guidelines.
• Monitor claim status and proactively follow up on unpaid, denied, or rejected claims.
• Investigate and resolve billing discrepancies, denials, underpayments, and appeals.
• Post insurance payments, adjustments, and patient payments accurately.
• Communicate with insurance companies regarding claim status, authorizations, and reimbursement issues.
• Maintain accurate patient accounts and billing records within the electronic health record (EHR) and billing systems.
• Collaborate with intake, customer support, clinical, and revenue cycle teams to resolve billing-related issues.
• Stay current on Medicare DMEPOS regulations, payer policies, HCPCS coding updates, and billing best practices.
• Assist with audits and ensure compliance with HIPAA and applicable federal and state regulations.
• Meet productivity, quality, and accounts receivable (A/R) performance goals.

Required Qualifications:

• 2+ years of medical billing experience, including at least 1 year of Durable Medical Equipment (DME) billing.
• Strong knowledge of Medicare DMEPOS billing guidelines and commercial payer requirements.
• Experience with electronic medical records (EHR) and medical billing software.
• Familiarity with ICD-10, HCPCS, and CPT coding related to DME billing.
• Excellent attention to detail, organizational, and problem-solving skills.
• Strong written and verbal communication skills.
• Proficiency with Microsoft Office, particularly Excel.

Preferred Qualifications:

• Certified Professional Biller (CPB) or equivalent certification.
• Experience using NikoHealth EHR.
• Experience using HubSpot CRM or similar customer relationship management (CRM) platforms.
• Experience with Brightree, Waystar, or other DME billing platforms.
• Knowledge of prior authorization and medical necessity documentation requirements.
• Experience in a multi-state healthcare environment.

Key Competencies:

• Attention to detail
• Analytical thinking
• Time management and organization
• Customer service orientation
• Revenue cycle knowledge
• Ability to prioritize and manage multiple tasks
• Collaborative team player
• Physical Requirements
• Ability to work at a computer for extended periods.
• Occasional lifting of up to 15 pounds.
• Ability to communicate effectively via phone, email, and virtual meetings.

Independent Contractor Perks:

• Permanent work from home
• Immediate hiring
• Health insurance coverage for eligible locations

Note:

Please click the Apply button to complete your application, including the assessment questions, technical check, and voice recording. Your hourly pay rate will be established based on your performance in the application process; submissions with all requirements fulfilled will receive priority review.