ABOUT THE DME BILLING SPECIALIST ROLE AT GENHEALTH
GenHealth.ai is transforming the way healthcare works, and we are looking for a highly detail-oriented and experienced DME Billing Specialist to join our team. In this role, you will ensure clean claims, accurate documentation, and timely reimbursement while working closely with our provider partners, engineering teams, and internal revenue cycle stakeholders. Your expertise will help streamline operations and support our mission to improve patient outcomes through innovative healthcare technology.
Responsibilities
- Prepare, submit, and track DME claims to Medicare, Medicaid, and commercial payers.
- Verify coverage, benefits, and authorization requirements to ensure clean claim submission.
- Review clinical documentation, prescriptions, and CMNs/SMNs for accuracy and completeness.
- Work claim rejections and denials, and submit timely appeals with appropriate documentation.
- Prepare and respond to insurance audits, recoupments, and payer requests.
- Analyze denial codes, identify root causes, and document trends for internal review.
- Ensure compliance with payer guidelines, LCDs, and audit standards.
- Post payments, reconcile accounts, and resolve discrepancies in a timely manner.
- Communicate professionally with providers, referral partners, and patients as needed.
- Maintain accurate billing records while consistently meeting productivity and quality benchmarks.
- Monitor aging reports and support efforts to reduce DSO.
- Review stop/hold reports and ensure follow-up is completed.
- Maintain and monitor payer fee schedules.
- Support month-end processes and internal reporting requirements.
- Additional responsibilities as needed to support the revenue cycle and billing team.
Requirements
- 1–3+ years of DME billing experience preferred.
- Strong understanding of HCPCS codes, modifiers, PA requirements, and payer-specific rules.
- Familiarity with Medicare guidelines and DMEPOS regulatory requirements.
- Experience using DME billing platforms such as Brightree, NikoHealth, or similar systems.
- Exceptional attention to detail with a commitment to accuracy.
- Strong written and verbal communication skills.
- Ability to troubleshoot issues, solve problems independently, and work efficiently under deadlines.
Nice to Have
- Experience with CGM, PAP, mobility, resupply, or other specialty DME product lines.
- Knowledge of RCM metrics, denial trends, and reporting.
- Prior experience working in a high-volume billing environment.
Compensation & Benefits
The salary for this role is $45,000 – $75,000. In addition to salary, total compensation includes the following:
- Healthcare, dental, and vision insurance for your entire family
- Unlimited vacation and 15+ company holidays per year
- Work directly with the founders
At GenHealth.ai, we are transforming the healthcare industry with cutting-edge Generative AI technology. As an Engineer at our company, you will work on projects that will improve the lives of millions of patients around the world. If you are passionate about using AI to make a significant impact on the healthcare industry and have experience in scaling Transformer Neural Network in production, we encourage you to apply today!
We take pride in our focus on equity. We are a proud equal opportunity employer and encourage individuals from all backgrounds and identities to apply for this position. We believe in fostering an inclusive and diverse workplace and are committed to supporting our employees’ professional growth and development.