You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.
Job Summary
We are seeking a highly strategic and detail-oriented Compliance Director to lead our Durable Medical Equipment (DME) intake, qualification, and policy alignment teams. In this critical leadership role, you will be the architect of our front-end revenue cycle, ensuring that all incoming orders are processed with seamless efficiency, zero friction, and absolute clinical accuracy. You will bridge the gap between operations, payer guidelines, and clinical documentation, ensuring that every order is audit-ready before it ever hits billing. Your ultimate goal is to maximize clean claim rates, drastically reduce front-end denials, and maintain ironclad adherence to Medicare, Medicaid, and commercial payer policies.
Key Responsibilities
- Streamline the entire front-end intake process, including order receipt, data entry, insurance verification, and prior authorization.
- Implement workflows that minimize turnaround time from order receipt to equipment delivery while maintaining strict quality controls.
- Establish and monitor Key Performance Indicators (KPIs) for the front-end team, such as Days to Authorize, Intake Error Rates, and First-Pass Clean Claim Rates.
- Serve as the company’s subject matter expert on all DMEPOS payer policies, Local Coverage Determinations (LCDs), and National Coverage Determinations (NCDs).
- Proactively track, interpret, and implement updates from CMS (Medicare), Medicaid, and private commercial payers.
- Oversee the clinical review process to ensure all physician orders, Certificates of Medical Necessity (CMNs), and standard written orders (SWOs) meet strict regulatory frameworks.
- Lead, mentor, and scale a high-performing team of intake specialists, authorization coordinators, and compliance reviewers.
Qualifications
- Minimum of 5–7 years of progressive leadership experience in DME/DMEPOS Revenue Cycle Management, specifically focused on intake and front-end operations.
- Deep, unshakeable knowledge of Medicare LCDs, NCDs, HIPAA regulations, and the Office of Inspector General (OIG) compliance guidelines for DME.
- Bachelor’s degree in Healthcare Administration, Business, or a related field required. Clinical credentials (RN, LPN, RRT) or advanced coding/compliance certifications (e.g., CHC, CPC) are highly preferred.
- Advanced proficiency with industry-standard DME software (e.g., Brightree, CareCentrix, Bonafide) and automated prior-authorization platforms.
Skills
- Proven track record of turning complex data and denial metrics into structured, efficient operational workflows.
- A knack for finding and fixing bottlenecks in high-volume environments.
- Ability to manage a fast-paced team and make firm calls on compliance risks.
- Exceptional communication skills capable of translating rigid legal/payer jargon into simple, executable steps.
Additional Requirements
Can be remote but travel to the main office will be required, starting biweekly and may eventually become quarterly.
Benefits
- Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
- Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
- 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
- Short Term Disability Insurance.
- Term Life Insurance Plan.
Required Employment / Compliance Language
Medix is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.
*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).
Medix Overview:
With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.
*As a job position within our Revenue Cycle division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, handling financial and other payment data, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.
