DME Documentation & Criteria Reviewer

DME Documentation & Criteria Reviewer

DME Documentation & Criteria Reviewer

Remotive

Remotive

Remote

2 days ago

No application

About

About Tennr:

When you go to your doctor and need to be referred to a specialist (e.g., for sleep apnea), your doctor sends a fax (yes, in 2024, 90% of provider-provider communication is a 1980s fax). These are often converted into 20+ page PDFs, with handwritten (doctor’s handwriting!) notes, in thousands of different formats. The problem is so complex that a person has to read it, type it up, and manually enter your information. Tennr built RaeLLM™ (7B—trained on 3M+ documents) to read these docs, talk to your doc to ensure nothing is missed, and text you to help schedule your appointment so you can get better, faster.

Tennr is a NYC-based tech company that launched out of Y-Combinator and is backed by Lightspeed Venture Partners, Andreessen Horowitz, Foundation Capital, The New Normal Fund, and other top investors.

About the Role

If you’ve worked in front-end intake, quality control, operations compliance, or audit review in the DME space, this is an opportunity to apply that experience in a new way. We’re growing our documentation and criteria review team to help ensure our platform accurately applies qualification logic based on Medicare, Medicaid, and commercial payer policies.

This is a detail-oriented, hands-on role focused on reviewing clinical documentation, assessing model-generated qualification outcomes, and identifying when decisions do or do not align with real-world payer standards.

We are hiring for both full-time and part-time contract positions.

What You’ll Do
  • Review the model’s outputs to improve criteria determinations

  • Flag incorrect determinations, including false positives, false negatives, and unclear logic, with structured feedback

  • Compare documentation against Medicare, Medicaid, and commercial payer coverage policies

  • Analyze source materials (insurance policies, LCDs, etc.) to help validate qualification logic

  • Work closely with internal teams to refine prompting logic and improve documentation review standards

  • Maintain clear documentation of findings and contribute to process improvements

Who You Are
  • You have hands-on DME experience in roles such as intake, documentation review, audits, or quality/compliance

  • You are confident identifying when documentation meets or fails to meet payer requirements

  • You are comfortable reviewing insurance coverage policies and applying them to real-world cases

  • You are highly organized, detail-focused, and confident making policy-based decisions

  • You work well independently and value open communication within a remote team setting

Preferred Experience
  • 4+ years working in DME, ideally in documentation review, intake, audits, or compliance roles

  • Familiarity with Medicare, Medicaid, and commercial payer guidelines for DME

  • Understanding of HCPCS codes and common DME categories such as respiratory, mobility, and maternal health

  • Experience with audits or appeals is a strong plus

  • Familiarity with decision logic or rules-based platforms is helpful but not required

If you are looking to use your DME knowledge in a meaningful way and want to help shape how technology supports accurate and efficient qualifications, we would love to connect.