Medicare DME Billing & AR Specialist

Core Responsibilities

• Submit clean Medicare Part B DME claims
• Monitor rejections and denials
• Perform corrected claim submissions
• Manage AR aging and follow-up cadence
• Cookordination with documentation team on claim corrections
• Maintain clean system notes and audit trail

30-60-90 Day Plan

• First 30 Days: Systems & Accuracy
• Learn company-specific DME workflows, payer mix, and billing policies
• Understand Medicare vs MA vs Commercial billing and reimbursement rules
• Review common denial reasons and payer turnaround timelines
• Submit and track claims under supervision
• Achie 90% claim accuracy by the end of 30 days
• Days 31-60: Ownership & Control
• Independently manage assigned claim and AR queues
• Resolve denials, rejections, and resubmissions end-to-end
• Cookordination with intake and documentation teams on root-cause issues
• Maintain accurate aging reports and follow-up cadence
• Reduce preventable denials by at least 20%
• Days 61-90: Optimization & Performance
• Identify payer trends affecting reimbursement speed or accuracy
• Improve clean-claim and first-pass payment rates
• Support appeals and recoupment defense
• Maintain 95%+ clean-claim submission rate and controlled AR aging

Requirements

• 2+ years Medicare DME billing experience
• Experience correcting and appealing denials
• Familiarity with clearinghouses and payer portals (Availity preferred)
• Experience with NikoHealth or similar DME system
• Strong written and spoken English
• Stable remote work environment
• Preferred: Urology or resupply billing experience
• CGM billing exposure