Valgorithm
1 - 10 employees
🤝 B2B
👥 HR Tech
🏢 Enterprise
B2B • HR Tech • Enterprise
Valgorithm is a fractional operations and people consultancy that helps early-stage companies scale their HR, operations, and technology systems. The firm offers fractional COO/CPO/CHRO services, operations and HR consulting, startup advisory, and technology/tool advisory, with particular experience serving healthcare and legal clients. Valgorithm focuses on building foundations for growth—designing tech stacks, implementing HR systems (onboarding, performance, compliance), improving operational efficiency, and reducing staffing and operational costs for B2B clients.
Medicare DME Billing, AR Specialist
🕒 February 12
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Valgorithm
1 - 10 employees
🤝 B2B
👥 HR Tech
🏢 Enterprise
B2B • HR Tech • Enterprise
Valgorithm is a fractional operations and people consultancy that helps early-stage companies scale their HR, operations, and technology systems. The firm offers fractional COO/CPO/CHRO services, operations and HR consulting, startup advisory, and technology/tool advisory, with particular experience serving healthcare and legal clients. Valgorithm focuses on building foundations for growth—designing tech stacks, implementing HR systems (onboarding, performance, compliance), improving operational efficiency, and reducing staffing and operational costs for B2B clients.
📋 Description
• Submit clean Medicare Part B DME claims • Monitor rejections and denials • Perform corrected claim submissions • Manage AR aging and follow-up cadence • Prevent timely filing expirations • Coordinate with documentation team on claim corrections • Maintain clean system notes and audit trail • 30-60-90 Day Plan**30–60–90 Day Success Plan – First 30 Days: Systems & Accuracy ** • Learn company-specific DME workflows, payer mix, and billing policies • Understand Medicare vs MA vs Commercial billing and reimbursement rules • Review common denial reasons and payer turnaround timelines • Submit and track claims under supervision • Achieve 90% claim accuracy by the end of 30 days • **Days 31–60: Ownership & Control ** • Independently manage assigned claim and AR queues • Resolve denials, rejections, and resubmissions end-to-end • Coordinate with intake and documentation teams on root-cause issues • Maintain accurate aging reports and follow-up cadence • Reduce preventable denials by at least 20% • **Days 61–90: Optimization & Performance ** • Fully own revenue cycle outcomes for assigned payors • Identify payer trends affecting reimbursement speed or accuracy • Improve clean-claim and first-pass payment rates • Support appeals and recoupment defense • Maintain 95%+ clean-claim submission rate and controlled AR aging
🎯 Requirements
• 2+ years Medicare DME billing experience • Experience correcting and appealing denials • Familiarity with clearinghouses and payer portals (Availity preferred) • Experience with NikoHealth or similar DME system • Strong written and spoken English • Stable remote work environment • Preferred: • Urology or resupply billing experience • CGM billing exposure
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