Full-Time DME Documentation & Criteria Reviewer

About Tennr:When you go to your doctor, your doctor often sends faxes (yes, in 2024). These faxes often become 20+ page PDFs with handwritten notes. Tennr uses AI to read these docs, talk to the doctor, and text you to help schedule your appointment.

About the Role:

We're hiring for a Documentation & Criteria Reviewer role. You'll review clinical documentation, assess model outputs for accuracy, and identify when decisions don't align with payer standards.

1. Review the model’s outputs for accuracy.
2. Flag incorrect determinations (false positives, false negatives, unclear logic) with structured feedback.
3. Compare documentation against Medicare, Medicaid, and commercial payer coverage policies.
4. Analyze source materials (insurance policies, LCDs) to validate qualification logic.
5. Work with internal teams to refine prompting logic and improve review standards.
6. Maintain clear documentation of findings and contribute to process improvements.

Who You Are:

• Hands-on DME experience (intake, documentation review, audits, quality/compliance)
• Confident in identifying when documentation meets payer requirements
• Comfortable reviewing insurance coverage policies and applying them
• Highly organized, detail-focused, and confident making policy-based decisions
• Independent worker with excellent communication skills

Preferred Experience:

• 4+ years in DME, ideally in documentation review, intake, audits, or compliance.
• Familiarity with Medicare, Medicaid, and commercial payer guidelines for DME.
• Understanding of HCPCS codes and common DME categories.
• Experience with audits or appeals is a plus
• Familiarity with decision logic or rules-based platforms is helpful but not required.

What is the last date for applying to the job?

Which countries are accepted for this remote job?