DME Accounts Receivable Supervisor

We are seeking an experienced and detail-oriented Billing Supervisor to lead our Durable Medical Equipment (DME) billing operations with a focus on surgical dressings and Medicare Part B claims. This leadership role requires hands-on supervisory experience in Skilled Nursing Facility (SNF) and Assisted Living Facility (ALF) settings, and expertise in Medicare compliance, documentation standards, and claim adjudication.

Responsibilities include:

• Supervising and mentoring billing team members on DME billing best practices, payer policies, and compliance.
• Overseeing Medicare Part B billing for surgical dressings and related DME products, including claim submission and denial management.
• Ensuring accurate documentation and coding (HCPCS codes, ICD-10 diagnosis codes) according to Medicare coverage determinations.
• Collaborating with clinical and administrative teams in SNF and ALF to obtain necessary documentation and verify patient eligibility.
• Monitoring billing metrics such as clean claim and denial rates; generating reports.
• Leading root-cause analyses for claim denials and implementing corrective measures.
• Conducting internal audits to ensure Medicare and HIPAA compliance.
• Staying updated on CMS, LCD/NCD changes affecting DME and surgical dressing billing.
• Training staff on payer-specific requirements and billing workflows.
• Acting as point of contact for payer audits, Targeted Probe and Educate (TPE) reviews, and recovery audit inquiries.

Required Qualifications:

• Minimum 3 years experience in DME billing, focusing on surgical dressings and wound care supplies.
• Knowledgeable in Medicare Part B DME claims, HCPCS Level II coding, and coverage criteria.
• Skilled in Medicare enrollment, eligibility verification, ABNs, and prior authorizations.
• Proficient with DME billing software and practice management systems.
• Strong understanding of HIPAA compliance, fraud and abuse regulations, and Medicare billing rules.
• Detail-oriented with strong organizational and multi-tasking skills.

Preferred Qualifications:

• Supervisory or team lead experience in healthcare billing.
• Experience working with SNF and ALF patient populations.
• Certified Professional Coder (CPC), Certified Medical Reimbursement Specialist (CMRS), or equivalent.
• Familiarity with TPE reviews, RAC audits, or MAC audit responses.
• Experience with EHR systems in SNF/ALF settings.
• Knowledge of Medicaid and Medicare Advantage secondary billing.
• Background in wound care or clinical supply chain a plus.