Medical Coder and Biller

Position Overview

MODERN DME LLC is seeking a detail-oriented Medical Biller and Coder to support accurate coding, claim submission, payment posting, account reconciliation, and insurance follow-up for durable medical equipment (DME) services and products.

This position works closely with billing, operations, clinical documentation, insurance, and customer service teams to ensure claims are submitted accurately, documentation requirements are addressed, and outstanding accounts are followed through resolution.

Key Responsibilities

Medical Billing & Claims

• Prepare and submit accurate claims to Medicare, Medicaid, commercial insurers, and other applicable payers.
• Review billing information for completeness and accuracy before claim submission.
• Verify patient, payer, provider, order, and equipment information.
• Monitor claim status and follow up on unpaid or delayed claims.
• Research rejected and denied claims and coordinate appropriate corrections.
• Maintain accurate billing records and claim documentation.

Coding & Charge Review

• Assign and verify appropriate diagnosis, procedure, supply, and equipment-related codes based on available documentation.
• Review orders and supporting documentation for coding and billing accuracy.
• Identify coding discrepancies and obtain clarification when necessary.
• Apply applicable coding guidelines and payer-specific billing requirements.
• Assist with reviewing HCPCS codes, modifiers, quantities, and other billing elements relevant to DME claims.

DME Documentation Support

• Review documentation supporting medical necessity and equipment orders.
• Verify that required information is present before claims are submitted.
• Coordinate with internal teams and referral sources to obtain missing documentation.
• Maintain organized records related to prescriptions, orders, authorizations, delivery documentation, and claims.
• Help identify documentation issues that may contribute to claim denials.

Insurance & Payer Follow-Up

• Contact insurance companies and payer representatives regarding claim status, eligibility, payment, and billing questions.
• Research payer-specific requirements and communicate necessary corrections.
• Document payer interactions and follow-up activities.
• Track outstanding claims and prioritize accounts requiring additional action.
• Escalate complex payer issues when appropriate.

Payment Posting & Account Reconciliation

• Post insurance and patient payments accurately to customer accounts.
• Review remittance advice and explanation-of-benefits information.
• Reconcile payments, adjustments, denials, and outstanding balances.
• Identify discrepancies between submitted claims, payer payments, and account balances.
• Assist with account research and resolution of billing discrepancies.

Denials & A/R Management

• Review denied, rejected, and underpaid claims.
• Determine the reason for claim issues and identify appropriate next steps.
• Submit corrected claims, reconsiderations, or supporting documentation when appropriate.
• Maintain accurate accounts-receivable notes and follow-up records.
• Monitor aging accounts and work outstanding balances toward resolution.

Compliance & Quality Control

• Follow applicable payer requirements, billing guidelines, coding standards, and company procedures.
• Protect confidential patient and business information.
• Review billing work for accuracy and completeness.
• Maintain appropriate documentation for audits and payer reviews.
• Report recurring billing or coding issues to management.
• Support process improvements designed to reduce errors and prevent avoidable denials.

Reporting & Administrative Support

• Maintain billing spreadsheets, claim logs, denial reports, and account-tracking systems.
• Prepare routine billing and accounts-receivable reports.
• Track claim submission, payment, denial, and follow-up activity.
• Assist management with identifying trends in billing performance and outstanding accounts.
• Support other revenue-cycle projects as assigned.

Qualifications

Required

• High school diploma or equivalent.
• 2+ years of experience in medical billing, medical coding, healthcare revenue cycle, insurance billing, or a related field.
• Strong understanding of healthcare billing and claims processes.
• Familiarity with ICD-10-CM and HCPCS coding.
• Strong attention to detail and accuracy.
• Ability to research claim issues and resolve billing discrepancies.
• Strong written and verbal communication skills.
• Proficiency with billing software, electronic records, spreadsheets, and payer portals.
• Ability to manage multiple accounts, deadlines, and follow-up activities.

Preferred

• Experience with DME/DMEPOS billing.
• Experience billing Medicare, Medicaid, or commercial insurance plans.
• CPC, CCA, CCS, CPB, or another relevant billing/coding certification.
• Familiarity with DME medical-necessity and documentation requirements.
• Experience with electronic claim submission and clearinghouse systems.
• Knowledge of payer-specific claim edits, modifiers, authorization requirements, and denial processes.
• Experience with accounts receivable and revenue-cycle reporting.

Core Competencies

• Medical billing
• Medical coding
• DME/DMEPOS billing
• Claims submission
• ICD-10-CM & HCPCS
• Insurance follow-up
• Denial resolution
• Accounts receivable
• Payment posting
• Account reconciliation
• Documentation review
• Payer communication
• Data accuracy
• Confidentiality
• Problem solving
• Revenue-cycle management

Pay: $24.64 - $29.68 per hour

Benefits:

• 401(k)
• Flexible schedule
• Health insurance
• Paid time off

Work Location: Remote