# Senior DME Operations & Revenue Integrity Specialist

> Valgorithm · Fort Lauderdale, United States · Full-time · Posted 2026-02-12

**Workplace:** on_site

**Department:** Patient Experience & Operations

## Description

### About [Ease DME](https://easedme.com)

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.

### Position Summary

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.

### Core Responsibilities

**Documentation & Compliance**

-   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

**Insurance & Revenue Readiness**

-   Verify Medicare, MA, and commercial eligibility
-   Confirm frequency limitations and coverage requirements
-   Ensure claims are documentation-complete prior to submission

**Denial Prevention & Revenue Oversight**

-   Analyze denial root causes
-   Improve clean-claim rate
-   Support appeals and recoupments
-   Monitor AR trends and timely filing limits

**Process Development**

-   Strengthen Order workflows
-   Build documentation checklists
-   Contribute to scalable team structure as volume grows

### 30-60-90 Day Plan

### **First 30 Days – Foundation & Familiarization**

**Goal:** Build a strong understanding of Ease DME’s billing systems, payer requirements, and compliance standards.  
**Milestones:**

-   Complete onboarding and training on NikoHealth, payer portals, and internal workflows.
-   Review 20+ recent claims and denials to identify common issues.
-   Learn Medicare and commercial payer rules for urology supplies (catheters, frequency limits, modifiers).
-   Shadow senior billing staff to understand claim submission and follow-up cadence.
-   Achieve 90% accuracy on supervised claim submissions.

### **Days 31–60 – Ownership & Efficiency**

**Goal:** Take ownership of assigned billing queues and begin improving clean-claim rates.  
**Milestones:**

-   Independently manage daily claim submissions and follow-ups.
-   Reduce preventable denials by 15–20% through proactive documentation checks.
-   Demonstrate consistent use of NikoHealth notes and task tracking.
-   Identify recurring documentation or intake issues and communicate with the intake team.
-   Maintain ≥93% clean-claim submission rate.

### **Days 61–90 – Optimization & Leadership**

**Goal:** Drive measurable improvements in revenue cycle performance and compliance.  
**Milestones:**

-   Fully own billing and AR management for assigned payers.
-   Maintain ≥95% clean-claim submission rate and reduce aging >60 days by measurable percentage.
-   Lead at least one process improvement initiative (e.g., denial prevention workflow).
-   Support audit readiness by ensuring documentation completeness.
-   Mentor intake staff on documentation best practices impacting billing.

### Why This Role Matters

This hire directly protects:

-   Medicare billing privileges
-   ACHC accreditation
-   Revenue integrity
-   Audit exposure

We are seeking someone who thinks:  
“Would this survive a Medicare audit?”

### Compensation

Competitive base salary with performance bonuses tied to:

-   Clean-claim rate
-   Preventable denial reduction
-   Documentation audit score

## 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

Preferred:

-   Diabetes / CGM billing experience
-   ACHC or audit exposure
-   Prior workflow or team-building experience

## Apply

[Apply at Valgorithm](https://apply.workable.com/valgorithm/j/A08315C75E/apply)

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