Workers Compensation Billing Specialist

2 days ago

Louisville, Kentucky, United States M. Joseph Medical Full time

Job Overview

Job Title: Workers' Compensation DME Billing Clerk Job Location: Middletown, KY

Reports to: Controller

Job type: Full Time

Position Summary

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 companypolicies.
  • Assist with prior authorization requests, medical documentation collection, and appealpreparation when necessary.
  • Provide exceptional customer service to patients, payers and referral sources regardingbilling 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 taskseffectively 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
  • Standard business hours

Job Type: Full-time

Pay: $38, $42,000.00 per year

Benefits:

  • 401(k)
  • Dental insurance
  • Health insurance
  • Paid time off
  • Vision insurance

Work Location: In person

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