Medicare DME Billing, AR Specialist

Job Description:

• Submit clean Medicare Part B DME claims
• Monitor rejections and denials
• Perform corrected claim submissions
• Manage AR aging and follow-up cadence
• Prevent timely filing expirations
• Coordinate with documentation team on claim corrections
• Maintain clean system notes and audit trail30-60-90 Day Plan

30–60–90 Day Success 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
• Achieve 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
• Coordinate 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

• Fully own revenue cycle outcomes for assigned payors

• 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 environmentPreferred:
• Urology or resupply billing experience
• CGM billing exposure

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