Senior DME Operations & Revenue Integrity Specialist
About The Position
Ease DME is a compliance-forward Durable Medical Equipment provider specializing in urology supplies. We are building a highly controlled, audit-ready Medicare DME operation and are seeking our first senior operations hire. This role protects compliance, cash flow, and accreditation integrity. The Senior DME Operations & Revenue Integrity Specialist owns front-end documentation compliance, insurance verification, and revenue readiness for Medicare and commercial claims. This individual ensures what ships is billable and what bills is defensible. This is not a clerical intake role. This is a high-accountability Medicare DME position.
Requirements
- 3+ years Medicare Part B DME billing experience
- Urology supply (catheter) billing or documentation experience
- Hands-on denial correction and appeals experience
- Experience using NikoHealth or similar DME system
- Strong written and verbal English communication
- Ability to think critically under compliance pressure
Nice To Haves
- Diabetes / CGM billing experience
- ACHC or audit exposure
- Prior workflow or team-building experience
Responsibilities
- Review physician orders and supporting medical records
- Validate medical necessity for straight, coude, and closed system catheters
- Ensure frequency limits and diagnosis alignment meet Medicare standards
- Maintain audit-ready patient files in NikoHealth
- Escalate documentation risks before shipment
- Verify Medicare, MA, and commercial eligibility
- Confirm frequency limitations and coverage requirements
- Ensure claims are documentation-complete prior to submission
- Analyze denial root causes
- Improve clean-claim rate
- Support appeals and recoupments
- Monitor AR trends and timely filing limits
- Strengthen Order workflows
- Build documentation checklists
- Contribute to scalable team structure as volume grows
Benefits
- Competitive base salary with performance bonuses tied to:
- Clean-claim rate
- Preventable denial reduction
- Documentation audit score
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
