Revenue Cycle Specialist / DME Biller

Position Overview

Prevail Health Services is a growing company focused on providing high-quality compression care and DME support to patients with lymphedema and related conditions. Our team is committed to responsive service, accurate documentation, strong follow-through, and top-tier patient care.

This office-based role is ideal for a skilled DME billing professional with strong Medicare and commercial insurance knowledge, a positive and professional communication style, and the ability to collaborate effectively across departments. After successful completion of the 90-day probationary period, Fridays may be worked from home.

The Revenue Cycle Specialist / DME Biller will take ownership of the full reimbursement process from claim submission through final payment resolution. This is not a basic data-entry billing role. The right candidate will understand the complexities of DME reimbursement, payer requirements, documentation standards, denials management, appeals, and accounts receivable follow-up.

This position requires someone who understands that billing is an important part of the patient care process, as timely and accurate reimbursement supports continued service excellence, operational success, and the company’s ability to provide top-tier care.

Key Responsibilities

Billing and Claims Management

• Submit and manage DME claims for Medicare, commercial, and secondary insurance payers
• Process high-volume claim submissions accurately and timely
• Manage ongoing billing for recurring and repeat patient claims
• Maintain accurate claim documentation and billing records
• Review claims for completeness before submission to reduce denials and reimbursement delays
• Work closely with intake, clinical, and operations teams to ensure documentation is complete before billing
• Monitor claim activity and follow claims through payment resolution

Accounts Receivable Management

• Proactively manage and work aging AR
• Identify and resolve unpaid, denied, or underpaid claims
• Maintain consistent payer follow-up to maximize reimbursement
• Monitor claim status and resolve billing issues in a timely manner
• Prioritize high-dollar and aging accounts for escalation and resolution
• Communicate reimbursement barriers and trends to leadership when appropriate

Denials and Appeals

• Investigate and resolve claim denials
• Prepare and submit payer appeals with supporting documentation
• Understand Medicare LCD/NCD requirements and payer-specific billing guidelines
• Identify denial trends and communicate process improvement opportunities
• Collaborate with intake and clinical teams to prevent recurring denials
• Ensure appeals are handled with accuracy, urgency, and proper documentation support

System and Documentation Management

• Utilize Brightree for billing, claim management, documentation review, and account follow-up
• Maintain accurate patient accounts and billing records
• Understand and apply appropriate HCPCS codes, modifiers, and documentation requirements
• Ensure compliance with Medicare, commercial payer, and company policies
• Review documentation for billing readiness and escalate missing information when needed
• Maintain organized account notes and follow-up activity

Team and Company Support

• Contribute to a positive, professional, and collaborative workplace culture
• Communicate clearly and professionally with team members across departments
• Support cross-functional coordination between billing, intake, clinical, and operations
• Adapt to changing workflows as the company continues to grow
• Assist with process improvement initiatives that support reimbursement, compliance, and patient care
• Demonstrate accountability, follow-through, and ownership of assigned work

Required Qualifications

• Minimum of 2+ years of DME billing experience
• Hands-on experience with Brightree
• Strong knowledge of Medicare billing
• Strong knowledge of commercial insurance billing
• Experience working aging AR, claim denials, insurance appeals, and payment follow-up
• Understanding of HCPCS codes, modifiers, and DME documentation requirements
• Ability to manage high-volume workloads and recurring patient billing cycles
• Strong organizational skills and attention to detail
• Ability to work independently and prioritize tasks effectively
• Strong professional communication and problem-solving skills
• Ability to maintain accuracy and urgency in a fast-paced environment

Preferred Qualifications

• Understanding of LCD/NCD policies
• Experience in a growing healthcare company or startup-style environment
• Knowledge of payer portals and insurance verification processes
• Experience identifying billing trends and recommending workflow improvements

Ideal Candidate

The ideal candidate is someone who takes ownership of their work, follows through without heavy oversight, and understands the importance of accuracy, timeliness, and reimbursement in the full patient care process. This person should be proactive, organized, professional, and comfortable working in a growing company environment where processes continue to improve as the company expands.

The right person will bring both technical billing knowledge and a team-focused approach. They should be able to communicate professionally, collaborate across departments, and contribute to a workplace culture that values accountability, respect, patient care, and operational excellence.

Why Join Prevail Health Services?

• Opportunity to grow with an expanding company
• Collaborative and supportive team environment
• Meaningful work that supports patient access to care
• Ability to make a direct impact on reimbursement, operations, and company success
• Opportunity to help improve processes as the organization continues to grow
• Long-term growth potential within the company

Pay: $60,500.00 - $75,000.00 per year

Benefits:

• Paid time off
• Professional development assistance

Experience:

• DME billing: 3 years (Preferred)
• Accounts receivable: 5 years (Preferred)
• Medical billing: 5 years (Preferred)

Work Location: Hybrid remote in Frisco, TX 75034