--- title: 'DME Documentation Criteria Reviewer at Hike Medical' canonical: 'https://feeny.ai/job/dme-documentation-criteria-reviewer-hike-medical-san-francisco-cwkw87x6pjhg' type: 'job' last_seen: '2026-09-16' --- # DME Documentation Criteria Reviewer at Hike Medical - **Company:** Hike Medical - **Location:** San Francisco, CA - **Compensation:** $90k–$145k - **Employment:** full-time - **Work type:** hybrid - **Posted:** 2026-06-18 - **Last confirmed live:** 2026-09-16 - **Apply:** https://jobs.ashbyhq.com/hike-medical/f5483d4d-dd72-4106-bd63-8f58be7ee7ff/application **Skills:** CMS Local Coverage Determinations, Policy Articles, Prior Authorization, Medicare FFS, UHC, Aetna, Cigna, HCPCS L-code, HCPCS L-code ranges for orthotics and prosthetics > Clinical analyst responsible for reviewing patient documentation against CMS LCD criteria and payer policies to identify gaps and ensure compliance. The role involves building criteria checklists, auditing reviews, and supporting prior authorization processes within a clinical intelligence platform. ## Job description ## About Hike Medical Hike Medical is building the defining company in musculoskeletal care. We sit at the intersection of AI, robotics, and healthcare, operating across three product lines: a proprietary AI-vision platform that turns a 30-second, web-based foot scan into custom 3D-printed orthotics; an AI agent platform that automates the entire DME workflow from pre-visit processing through claims and revenue cycle; and SoleForge, our vertically integrated 3D-printing factory producing custom medical devices at a scale the industry has never seen. Insoles today, full DME tomorrow, bionics by 2040. Custom insoles are just the wedge. Our long-term vision is bionics: AI-designed, robotically manufactured orthotic and prosthetic devices at scale, replacing a fragmented, manual industry that hasn’t changed in decades. Read the full vision at [bionics2040.com](http://bionics2040.com). We’re live across the industry’s largest national orthotics-and-prosthetics providers and tracking toward a $50M run rate by the end of 2026. We’ve stealthily raised $22M across Seed and Series A from top-tier investors who backed OpenAI, Anduril, and Mercury early, and we run a fast, results-first, high-ownership culture out of our SF Rincon Hill office. ## About the Center of Excellence The Center of Excellence is the intelligence engine of Hike. It owns the clinical and coding knowledge that powers every AI agent — producing agent guides per code block, setting evaluation standards, informing all compliance policies, and managing the human-in-the-loop team. CoE roles are the highest-leverage positions in the company: the documents and workflows you build determine how fast we expand into new device categories. ## The Role The DME Documentation Criteria Reviewer is the clinical analyst who turns medical necessity requirements into auditable, reviewable criteria sets. You review incoming patient documentation — physician notes, evaluations, prior authorization packets — against LCD criteria and payer policy, and identify exactly what is present, what is missing, and what can be obtained. You work inside our platform, and every review action you take becomes training data for the automation layer. ## What You Will Do - Review patient documentation for each device category against CMS LCD criteria and payer-specific requirements. - Identify documentation gaps and generate structured deficiency notices to clinicians and prescribers. - Build and maintain criteria checklists per code block, aligned with the Clinical Intelligence Lead's agent guides. - Audit HITL team reviews for criteria accuracy and consistency. - Flag payer-specific deviations (e.g., UHC requirements that differ from Medicare) and document them in the policy library. - Collaborate with the Protocol Specialist to update criteria sets when LCDs change. - Support prior authorization packet assembly, ensuring each packet maps to the coverage criteria for the relevant payer. ## What We Are Looking For - 3+ years reviewing DMEPOS documentation in a clinical, billing, or utilization management role. - Solid understanding of CMS Local Coverage Determinations and Policy Articles for O&P and DME categories. - Experience with prior authorization at Medicare FFS and major commercial payers (UHC, Aetna, Cigna). - Detail-oriented, comfortable with structured checklists and building systematic review processes. - Familiarity with HCPCS L-code ranges for orthotics and prosthetics preferred. - Experience at a DMEPOS supplier, O&P company, or managed care organizatio ## About Hike Medical ## Company Overview - **One-liner**: Hike Medical provides clinically proven, custom 3D-printed insoles and musculoskeletal (MSK) solutions to self-insured employers, aiming to reduce healthcare costs and improve employee well-being. - **Entity Type**: Private (Seed Stage) - **Headquarters**: Boston, Massachusetts, USA (with a manufacturing hub, SoleForge, in Peoria, Illinois, USA) - **Founded**: 2022 - **Founders**: Aadi Bhanti (CEO, Co-founder), Steven Chacko (CBO, Co-founder), Amit Bhanti (CPO, LPO, Co-founder) ## Core Business - **Primary industry/industries**: Healthcare Technology, Musculoskeletal (MSK) Health, Digital Health, Additive Manufacturing (3D Printing) - **Target customers**: Self-insured employers, health plans, and clinicians (B2B). The end-users are employees (B2B2C), particularly those in physically demanding roles like manufacturing and blue-collar industries. - **Mission or purpose statement**: "To ensure every employee has access to the care that keeps them moving, healthier, and more energized—starting with the feet." [linkedin.com](https://www.linkedin.com/company/hike-medical) ## Products & Services - **[Hike Custom Insoles]**: A SaaS-enabled physical product. The process involves a user scanning their feet with a smartphone (no app download needed), which uses AI and 3D vision to create a precise digital model. The insoles are then 3D-printed and hand-finished at the company's SoleForge manufacturing hub in Peoria, Illinois, and shipped directly to the user. This is a clinical-grade orthotic designed to prevent and alleviate foot pain and related MSK issues. [hikemedical.com](https://www.hikemedical.com/) - **[Ulcer Detection & Prevention Technology]**: An AI-powered capability to detect and monitor foot ulcers, announced as a novel feature to expand proactive care for at-risk populations. [linkedin.com](https://www.linkedin.com/company/hike-medical) ## Market Standing - **Valuation/Market Cap**: Not publicly available (Private company). - **Key Metric**: Total Funding of $7.0M (Seed Round, August 2025). [linkedin.com](https://www.linkedin.com/company/hike-medical) - **Notable Investors/Partners**: Key partners include OSF HealthCare. [linkedin.com](https://www.linkedin.com/company/hike-medical) - **Growth Signals**: The company has experienced massive headcount growth of +95.5% year-over-year, growing from a small team to 35 employees. It has expanded its operations to 5 countries (United States, United Kingdom, Spain, Canada, India). A key partnership with OSF HealthCare was announced in late 2024 to bring foot care to over 25,000 mission partners. [linkedin.com](https://www.linkedin.com/company/hike-medical) ## Competitive Advantages - **Proprietary 3D Scanning & AI**: Their "ShapeCapture" technology allows for a clinical-grade foot scan using any smartphone, removing the need for in-person appointments and making the process highly scalable. [hikemedical.com](https://www.hikemedical.com/) - **In-House 3D Printing (SoleForge)**: By owning the manufacturing process in Peoria, IL, they control quality, speed, and cost, enabling a direct-to-consumer model that bypasses traditional, expensive clinic-based orthotic supply chains. [hikemedical.com](https://www.hikemedical.com/) - **Focus on the Underserved**: The company specifically targets blue-collar and manufacturing workers—a demographic often overlooked by digital health solutions—addressing a massive, high-cost problem (foot pain and MSK issues) for self-insured employers. [datanyze.com](https://www.datanyze.com/companies/hike-medical/5000016150) - **Clinical & Compliance Backing**: The company is HIPAA compliant and SOC-2 certified, with a Chief Clinical Officer (Amit Bhanti, CPO, LPO) on the leadership team, lending clinical credibility. [hikemedical.com](https://www.hikemedical.com/) ## Strategic Focus - **Scaling B2B Sales**: The company is actively hiring for enterprise sales roles (VP of Employer Sales, Enterprise Account Executives, Channel Account Executives) to grow its footprint with self-insured employers. [builtin.com](https://builtin.com/company/hike-medical) - **Deepening AI & 3D Vision Capabilities**: They are hiring Senior Machine Learning Engineers for "Multimodal AI" and "3D Vision," indicating a focus on improving their scanning technology and expanding into other diagnostic areas like ulcer detection. [builtin.com](https://builtin.com/company/hike-medical) - **Manufacturing Innovation**: The hiring of a Senior Software Engineer for the "3D Print Farm" in Peoria, IL, signals a focus on optimizing and scaling their in-house additive manufacturing operations. [builtin.com](https://builtin.com/company/hike-medical) - **Expanding Clinical Partnerships**: The partnership with OSF HealthCare is a key strategic move to validate their model within a large healthcare system and expand their reach. [linkedin.com](https://www.linkedin.com/company/hike-medical) ## Why Work Here - **High-Growth Environment**: With a 95.5% headcount growth rate in the last year, the company is in a rapid scaling phase, offering significant opportunities for impact and career advancement. [linkedin.com](https://www.linkedin.com/company/hike-medical) - **Mission-Driven Work**: The company is focused on solving a tangible, widespread problem—foot pain and MSK issues for hardworking Americans—which provides a strong sense of purpose. [hikemedical.com](https://www.hikemedical.com/) - **Innovative Tech Stack**: The engineering team works with modern technologies including Ruby, React, React Native, GraphQL, and GitHub, and is pushing the boundaries of AI, 3D vision, and additive manufacturing. [builtin.com](https://builtin.com/company/hike-medical) - **Flexible Work Environment**: The company offers a hybrid workspace with a "flexible" on-site policy. They have worksites in the Chicagoland area and Peoria, IL, with a salary premium for those willing to relocate to Peoria. [builtin.com](https://builtin.com/company/hike-medical) - **Young, Mission-Driven Team**: The company was founded in 2022 and is described as having a "young founding team" focused on solving a real problem for hardworking Americans. [builtin.com](https://builtin.com/company/hike-medical) ## Sources 1. [hikemedical.com](https://www.hikemedical.com/) 2. [linkedin.com](https://www.linkedin.com/company/hike-medical) 3. [builtin.com](https://builtin.com/company/hike-medical) 4. [datanyze.com](https://www.datanyze.com/companies/hike-medical/5000016150) ## Other roles at Hike Medical - [Founding Head of Talent](https://feeny.ai/job/founding-head-of-talent-hike-medical-san-francisco-5h6xx0d298nn) — San Francisco, CA - [Assistant Controller / Finance Manager](https://feeny.ai/job/assistant-controller-finance-manager-hike-medical-san-francisco-g2mxxy71ebs6) — San Francisco, CA - [RevOps Lead](https://feeny.ai/job/revops-lead-hike-medical-san-francisco-kds7et0q9jjx) — San Francisco, CA - [GTM Associate](https://feeny.ai/job/gtm-associate-hike-medical-san-francisco-03s4hsdrp8qh) — San Francisco, CA - [Talent Lead](https://feeny.ai/job/talent-lead-hike-medical-san-francisco-z2bpzwrp2sty) — San Francisco, CA - [Business Development Lead](https://feeny.ai/job/business-development-lead-hike-medical-san-francisco-hmj1kfhnrdj9) — San Francisco, CA - [Senior Machine Learning Engineer, Multimodal AI](https://feeny.ai/job/senior-machine-learning-engineer-multimodal-ai-hike-medical-san-francisco-tqb1yk738d9x) — San Francisco, CA - [Senior Software Engineer](https://feeny.ai/job/senior-software-engineer-hike-medical-san-francisco-nha1ajqh1q4e) — San Francisco, CA - [Compliance & Outcomes Specialist](https://feeny.ai/job/compliance-outcomes-specialist-hike-medical-san-francisco-7es0rv8dbr9m) — San Francisco, CA - [Criteria Project Manager](https://feeny.ai/job/criteria-project-manager-hike-medical-san-francisco-6k93tm5xa1v8) — San Francisco, CA