DME Compliance & Operations Manager
About The Position
Agility Medical Group is a rapidly growing healthcare organization focused on delivering high-quality Durable Medical Equipment (DME) services through innovative care models and operational excellence. We are seeking an experienced DME Compliance & Operations Manager to lead compliance oversight and daily billing operations while expanding our policies, procedures, and monitoring systems necessary to ensure regulatory adherence across all markets we serve. The DME Compliance & Operations Manager is responsible for establishing and maintaining the compliance framework for the organization’s DME operations while overseeing the daily performance of the billing team. This individual will ensure adherence to Medicare, Medicaid, commercial payer, and state regulatory requirements, while building scalable compliance processes as the organization grows. This is a hands-on leadership role for someone who understands the complexities of healthcare compliance and can translate regulatory requirements into operational processes that protect the organization and support sustainable growth. The role requires a deep understanding of billing, documentation requirements, audits, and supplier standards, along with strong operational leadership to drive performance within the revenue cycle team.
Requirements
- 5+ years of experience in operations or compliance
- Strong knowledge of Medicare DMEPOS billing requirements
- Experience managing or supervising DME billing teams
- Deep understanding of medical necessity documentation requirements
- Experience with audits, payer reviews, or accreditation processes
- Knowledge of state licensing requirements for DME suppliers
- Ability to develop and implement policies and operational procedures
Nice To Haves
- Bachelor’s degree in healthcare administration, business, or a related field.
- Experience with Brightree, TrueSight, Niko Health or similar DME billing platforms
- Experience working with Medicare, Medicaid, and commercial payer audits
- Experience supporting DME accreditation processes
- Knowledge of DME compliance monitoring programs
Responsibilities
- Develop and maintain DME compliance policies and procedures
- Ensure adherence to CMS DMEPOS Supplier Standards
- Monitor regulatory requirements for states served, particularly Oklahoma and Kansas
- Oversee internal compliance monitoring and documentation reviews
- Lead internal pre-billing and post-billing audits
- Implement processes to mitigate risk related to medical necessity, documentation, and billing
- Prepare the organization for Medicare, payer, and accreditation organization audits
- Partner with leadership to ensure compliance during expansion into new states
- Manage the daily operations of the DME billing team
- Supervise billing leads and ensure workflow efficiency
- Monitor claims accuracy, denial trends, and payer compliance
- Implement improvements to increase billing accuracy and reduce risk
- Partner with operations and clinical teams to ensure proper documentation before claims submission
- Support resolution of complex billing or payer issues
- Translate regulatory requirements into clear operational workflows
- Develop & Implement training programs for staff on compliance and documentation requirements
- Maintain documentation for accreditation and compliance audits
- Establish internal reporting and monitoring systems to track compliance risk
Benefits
- Competitive Salary: $85,000-$100,000 annually (DOE) + bonus opportunities
- Medical, Dental, and Vision Coverage
- Direct Primary Care & Telehealth Access
- Short- & Long-Term Disability + Voluntary Life Insurance
- 401(k) with Company Matching
- Paid Holidays & PTO
- AAA Membership
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
