Certified Professional Coder, DME

This is a fully remote position, open to applicants in United States.

📋 Description

• Act as the expert in coding and documentation for DME orders.

• Make final selections for HCPCS Level II codes, modifiers, and ICD-10-CM across CPAP, oxygen, hospital beds, enteral nutrition, mobility, and incontinence supplies.

• Conduct internal chart audits.

• Lead the responses to documentation requests from payors and DME MAC.

• Maintain audit-ready files as the volume of work increases.

• Collaborate with the RCM team to identify the root causes of denials and write-offs.

• Improve upstream coding and billing processes to minimize coding-related denials.

• Develop SOPs, criteria matrices, and training materials.

• Utilize coding and policy tools, claims systems, payor portals, Metabase, Google Sheets, Slack, and Google Workspace.

• Work in conjunction with the Revenue Cycle Management team.

⛳️ Requirements

• Active CPC (AAPC) or CCS (AHIMA) certification.

• A minimum of 3 years of coding or billing experience specifically in DMEPOS.

• Proficiency in HCPCS Level II and DME modifiers, including KX, GA, GY, GZ, RR, NU, UE, and RT/LT.

• Knowledge of ICD-10-CM coding that supports DME modifiers.

• Familiarity with DME MAC LCDs and policy articles.

• Understanding of standard written order and proof of delivery rules.

• Knowledge of capped rental schedules.

• Familiarity with state Medicaid DME manuals and commercial medical policies.

• Hands-on experience with denials and appeals.

• Ability to differentiate between coding, documentation, and contract issues from remits.

• Capability to write successful appeals.

• Experience in creating SOPs, criteria matrices, and training materials.

• Strong skills in spreadsheet applications.

• Ideally, experience in generating independent reports.

• Comfort with ambiguity and the ability to execute tasks rapidly.

🏝️ Benefits

• 100% employer-covered health insurance premium.

• Dental and vision insurance plans available for employees and their dependents.

• 401(k) plan with no current company match.

• Opportunities for rapid career advancement.

• Fully remote work environment.

• Optional access to the Chelsea office in New York City without any onsite expectations.