The Workers’ Compensation DME (Durable Medical Equipment) Billing Clerk is responsible for accurately preparing, submitting, and following up on workers’ compensation claims related to DME services. This role ensures compliance with state regulations, payer guidelines, and company policies while supporting the revenue cycle and maintaining strong relationships with adjusters, case managers, vendors, front line DME customer service and patients.
Key Responsibilities
•
Prepare and submit workers’ compensation billing claims for DME services in accordance with payer and state-specific guidelines.
•
Verify claim accuracy, including coding, pricing, authorization, and supporting documentation before submission
•
Track and monitor claim status to ensure timely filing and reimbursement; follow up on denials, rejections, and outstanding balances.
•
Communicate with adjusters, case managers, and internal staff to resolve billing discrepancies.
•
Maintain accurate records of all billing activity, claim submissions, and payment posting.
•
Ensure compliance with HIPPA, state workers’ compensation regulations, and company policies.
•
Assist with prior authorization requests, medical documentation collection, and appeal preparation when necessary.
•
Provide exceptional customer service to patients, payers and referral sources regarding billing inquiries.
•
Support month-end reporting, reconciliation, and audits as required.
Qualifications
•
High school diploma or equivalent; additional training in medical billing or workers’ compensation preferred, but not necessary.
•
Knowledge of workers’ compensation billing regulations, fee schedules, and electronic claims submission processes preferred.
•
Proficiency in Microsoft Office Suite
Strong organizational skills, attention to detail, and ability to manage multiple tasks effectively is a must.
Excellent written and verbal communication skills.
Ability to work independently and collaboratively within a team environment.
Preferred Skills
Familiarity with CPT, and HCPCS coding for DME.
Knowledge of EOB/EOR interpretation and appeal processes.
Work Environment
Office Based.
Office Casual