DME Operations & Billing Specialist (CGM / Medicare)

About Med Supply US

Med Supply US is a rapidly growing healthcare company specializing in continuous glucose monitoring (CGM) supplies for patients with diabetes . We work closely with physicians and insurance providers to ensure patients receive the medical equipment they need while maintaining strict compliance with Medicare and insurance guidelines.

Our team combines healthcare operations, technology, and automation to streamline the patient experience and improve outcomes.

We are seeking an experienced DME Revenue Cycle & Operations Specialist who understands the unique requirements of Medicare billing, insurance follow-ups, and documentation for durable medical equipment .

Position Overview

The DME Revenue Cycle & Operations Specialist plays a key role in ensuring claims are processed correctly and payments are received efficiently. This role involves managing the lifecycle of claims related to continuous glucose monitor (CGM) supplies , including documentation review, insurance verification, claim submission, denial resolution, and coordination with internal teams.

Because much of our team operates remotely, maintaining an in-office presence is essential to support operations and ensure the office remains staffed .

Schedule:

• Monday – Thursday.
• 9:00 AM – 5:00 PM (in office).

Core Responsibilities:

Revenue Cycle & Billing:

• Process and submit claims for durable medical equipment (DME), specifically CGM supplies.
• Review patient documentation to ensure compliance with Medicare and payer requirements.
• Verify insurance eligibility and benefits for Medicare and PPO plans.
• Monitor claim status and follow up on unpaid claims.
• Investigate and resolve claim denials and rejections.
• Submit corrected claims and assist with appeals when necessary.
• Maintain accurate billing records and claim documentation.

Insurance & Claims Management:

• Work directly with insurance companies to obtain claim status updates.
• Analyze Explanation of Benefits (EOBs) and assist with payment posting.
• Coordinate with internal teams to resolve documentation issues that may impact billing.
• Identify billing issues that could delay reimbursement and escalate them appropriately.

Operations Support:

• Coordinate with intake, documentation, and patient support teams to ensure required paperwork is complete.
• Assist with gathering documentation from physician offices when needed.
• Maintain organized records and ensure all patient data is properly documented within internal systems.
• Support daily operational needs of the office to ensure efficient workflow.

Systems & Tools:

Experience with the following is preferred:

• Niko Health (strongly preferred).
• Medical billing or clearinghouse software.
• CRM systems used for patient and insurance management.
• Insurance portals for Medicare and commercial payers.

Required Qualifications:

• 2+ years experience in medical billing or durable medical equipment (DME) billing.
• Strong understanding of Medicare Part B billing processes.
• Familiarity with insurance claims lifecycle (submission, follow-up, denial resolution).
• Excellent organizational and attention-to-detail skills.
• Ability to manage multiple claims and insurance cases simultaneously.
• Strong communication skills when interacting with insurance companies and healthcare providers.

Highly Preferred Experience:

• Experience billing continuous glucose monitor (CGM) supplies.
• Experience using Niko Health.
• Knowledge of Medicare documentation requirements for diabetic supplies.
• Experience with claim appeals and denial management.
• Experience working with PPO plans and out-of-network billing.

What We Look For:
The ideal candidate is someone who:

• Understands the complexities of DME billing and Medicare compliance.
• Is highly organized and detail oriented.
• Can work independently and solve problems quickly.
• Communicates effectively with both insurance companies and internal teams.
• Takes ownership of their work and helps ensure claims are processed accurately and efficiently.

Compensation:

• Competitive compensation based on experience.