Quality Assurance Specialist, RCM/DME

Company Description

Today, when you go to your doctor and get referred to a specialist (e.g., for sleep apnea), your doctor sends out a referral and tells you, "They'll be in touch soon." So you wait. And wait. Sometimes days, weeks, or even months. Why? Because too often specialists and medical services are overwhelmed with referrals and the painstakingly manual process it takes to qualify your referral prevents them from getting around to it on time, or sometimes at all. Tennr prevents these delays and denials by making sure every referral gets where it needs to go, with the right info, at the right time. Powered by RaeLM Tennr reads, extracts, and acts on every piece of patient information so providers can capture more referrals, slash denials, and reduce delays.

Role Description

We are seeking a Quality Assurance Specialist with a strong background in Revenue Cycle Management and Durable Medical Equipment or Home Medical Equipment processes. This role ensures that every order, documentation set, and workflow meets compliance standards and payer requirements. The person will partner with operations, billing, and customer teams to guarantee accuracy and consistency, and you'll help translate customer or payer criteria into usable internal references.

Responsibilities

• Review and validate DME and HME orders for completeness, accuracy, correct product ordering, eligibility and documentation of medical necessity
• Verify insurance coverage and benefits verification workflows; handle intake through billing with attention to payer policy and documentation standards
• Interpret customer or payer-provided documentation, internal SOPs and criteria; translate into structured internal guidance, checklists or reference documents
• Collaborate with sales, operations, billing, and implementation teams to ensure alignment between order intake, documentation, and claim submission
• Participate in quality assurance audits, identify process gaps or risks, and recommend improvements to streamline workflows and reduce errors/denials
• Maintain and update internal policy/reference documents ("source of truth") for DME/HME coverage, payer rules, HCPCS/ICD-10 mapping, etc.

Candidate Qualifications

Required

• 1-3 years of experience in RCM, DME/HME billing or audit, or order intake/eligibility verification in a healthcare operations setting
• Solid working knowledge of HCPCS and ICD-10 coding, payer coverage rules (Medicare/Medicaid/private) and documentation requirements for medical necessity
• Experience or comfort with eligibility/benefits verification workflows, insurance coverage checks and prior authorization logic
• Strong attention to detail, good analytical/QA mindset, ability to spot inconsistencies and ensure documentation completeness
• Good communication skills, able to work with operational/clinical teams and translate requirements into internal guidance

Preferred

• Experience with DME/HME order intake in product categories like CPAP, urology, enteral or other durable/home medical equipment
• Experience with a billing/RCM system (e.g., Brightree or similar) or working in a healthcare SaaS/tech environment
• Familiarity with user acceptance testing (UAT), validation of implementation logic, or working in cross-functional teams (operations + product)

Why Tennr?

• Drive Impact: one of our company values is Cowboy, meaning you set the pace. You won't just talk about things, you'll get them done. And feel the impact.
• Develop Operational Expertise: learn the inner workings of scaling systems, tools, and infrastructure
• Innovate with Purpose: we're not just doing this for fun (although we do have a lot of fun). At Tennr, you'll join a high-caliber team maniacally focused on reducing patient delays across the U.S. healthcare system.
• Build Relationships: collaborate and connect with like-minded, driven individuals in our Chelsea office 4 days/week (preferred)
• Free lunch Plus a pantry full of snacks.

Benefits

• New, spacious Chelsea office
• Unlimited PTO
• 100% paid employee health benefit options
• Employer-funded 401(k) match
• Competitive parental leave

Compensation Range: $80K - $105K