Valgorithm

Medicare DME Billing, AR Specialist

Valgorithm

full-time

Posted on:

Location Type: Remote

Location: FloridaUnited States

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About the role

  • 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 trail
  • 30-60-90 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 environment
  • Preferred:
  • Urology or resupply billing experience
  • CGM billing exposure
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
Medicare DME billingclaim correctionsdenial managementAR aging managementclean-claim submissionreimbursement rulesappeals supportroot-cause analysisperformance optimizationbilling policies
Soft Skills
communicationorganizational skillsattention to detailproblem-solvingindependencecollaborationtime managementanalytical thinkingadaptabilitycustomer service