Aptiva Medical is a growing DME provider focused on making continuous glucose monitoring accessible to patients nationwide. The team works with Abbott and Dexcom to serve Medicare and commercially insured patients while improving revenue cycle processes and fixing problems at the source.
This role spends most of the day in the denial queue, reviewing EOBs, handling CARCs and payer rejections, filing appeals, calling payers, and working claims through payer portals until they are paid. The position also focuses on identifying the root causes of denials and partnering across intake, documentation, authorizations, contracting, and billing to prevent repeat issues.
The ideal candidate will help improve SOPs and best practices as the revenue cycle operation scales.
3+ years of experience in DME or CGM billing, denials, or reimbursement
Strong knowledge of Medicare CGM coverage, documentation requirements, and applicable LCDs
Working knowledge of CGM HCPCS codes:
- A4239
- E2103
- A9276
- A9277
- A9278
Ability to interpret CARCs and RARCs and resolve denials, not just reprocess them
Strong pattern-recognition skills and the ability to identify root causes across claim trends
Strong written and verbal communication skills
Preferred experience:
- Dexcom or FreeStyle Libre
- Waystar or HDMS
- Excel pivot tables for denial trend analysis
- Demonstrated success resolving denial patterns and implementing fixes
- Medical insurance
- Vision insurance
- Dental insurance
- Disability insurance
Location
Florida, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
1 month ago