Remote Revenue Cycle & Compliance Manager (Medicare Focus)

Koya Medical, Inc.; United States; Remote; USD 120,000 - 135,000; Full time

Benefits offered by this job

Remote work

Job summary

Koya Medical, Inc. is seeking a Manager of Compliance Audits to lead oversight of the DME order-to-payment lifecycle. You will design and execute risk-based audits, review eligibility, prior authorization, billing and payer requirements, and coordinate external payer audits.

This hands-on role develops controls, validates actions and reports findings to Compliance leadership. The ideal candidate has at least five years in healthcare compliance, Medicare DMEPOS experience, strong Excel skills,

Qualifications

• Bachelor’s degree in healthcare administration, accounting, finance, business or related field.
• At least five years in healthcare compliance with Medicare DMEPOS experience and two years independently leading audits or cross-functional improvement projects.
• Practical knowledge of the DME order-to-payment lifecycle, capped rentals, documentation, authorizations, payer requirements, and patient protections.
• Ability to design and execute an audit from inception through findings, root-cause analysis and corrective-action validation; experience supporting external payer audits.
• Strong Excel skills, data reconciliation, pivot tables, and clear findings reports for leadership.
• Discretion, cross-functional communication, and coaching abilities.

Responsibilities

• Lead risk-based audits and define objectives, criteria and evidence standards.
• Review intake, eligibility, benefits verification, orders, and payer requirements throughout the order lifecycle.
• Audit Medicare and commercial billing, payer contracts, and denials; review returns and overpayments.
• Analyze patient financial responsibility estimates and communications; escalate repayment or legal issues as needed.
• Prepare concise written findings and management-ready presentations; support policy updates and training.

Skills

Excel

Data analysis

Communication

Leadership

Education

Bachelor’s degree in healthcare administration, accounting, finance, business or related field

Tools

SQL

Power BI

Salesforce

Compliance software

Job description

Koya Medical, Inc. is seeking a Manager of Compliance Audits to lead oversight of the DME order-to-payment lifecycle. You will design and execute risk-based audits, review eligibility, prior authorization, billing and payer requirements, and coordinate external payer audits.

This hands-on role develops controls, validates actions and reports findings to Compliance leadership. The ideal candidate has at least five years in healthcare compliance, Medicare DMEPOS experience, strong Excel skills,