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About the role
Key responsibilities & impact- Serve as the coding and documentation expert for DME orders
- Make final HCPCS Level II, modifier, and ICD-10-CM selections across CPAP, oxygen, hospital beds, enteral nutrition, mobility, and incontinence supplies
- Run internal chart audits
- Lead responses to payor and DME MAC documentation requests
- Maintain audit-ready files as volume grows
- Partner with the RCM team to trace denials and write-offs to root causes
- Fix upstream coding and billing processes to reduce coding-driven denials
- Build SOPs, criteria matrices, and training materials
- Use coding and policy tools, claims systems, payor portals, Metabase, Google Sheets, Slack, and Google Workspace
- Collaborate with the Revenue Cycle Management team
Requirements
What you’ll need- Active CPC (AAPC) or CCS (AHIMA) certification
- 3+ years of coding or billing experience specifically in DMEPOS
- Fluency in HCPCS Level II and DME modifiers, including KX, GA, GY, GZ, RR, NU, UE, and RT/LT
- ICD-10-CM coding knowledge supporting DME modifiers
- Knowledge of DME MAC LCDs and policy articles
- Knowledge of standard written order and proof of delivery rules
- Knowledge of capped rental schedules
- Knowledge of state Medicaid DME manuals and commercial medical policy
- Hands-on denials and appeals experience
- Ability to distinguish coding, documentation, and contract problems from remits
- Ability to write successful appeals
- Ability to create SOPs, criteria matrices, and training materials
- Strong spreadsheet skills
- Ideally, experience pulling independent reporting
- Comfort with ambiguity and rapid execution
Benefits
Comp & perks- 100% employer-covered health insurance premium
- Dental and vision insurance plans for the employee and dependents
- 401(k) plan; no company match currently offered
- Opportunities for rapid career advancement
- Fully remote work
- Optional access to the Chelsea office in New York City with no onsite expectation