DME Documentation Specialist

ACU-Serve; United States; Remote; USD 38,000 - 52,000; Full time

Job summary

ACU-Serve seeks a DME Documentation Specialist for remote full-time work in the US. You will manage medical documentation to support medical necessity, obtain and maintain prior authorizations and CMNs, and ensure accurate coding and billing for DME items including oxygen and sleep therapy.

You should have 1 year of DME billing experience, knowledge of Medicare/Medicaid, and strong MS Word/Excel skills. Excellent communication and attention to detail are essential in a fast-paced team

Qualifications

• 1 year of experience in durable medical billing and insurance verification.
• Experience with DME intake processes including prior authorizations.
• Knowledge of Medicare, Medicaid and commercial payers policies.
• HS diploma or GED.
• Familiarity with HCPC documentation requirements.
• Strong MS Word and Excel skills, good keyboarding.

Responsibilities

• Collect, review and request medical documentation to support medical necessity for prior authorization.
• Submit and maintain prior authorizations and CMNs.
• Request documentation to support ongoing medical necessity for DME.
• Handle medical equipment orders including oxygen and sleep therapy.
• Create and update CMNs in DME billing software.
• Review CMNs and medical records for accuracy and completeness.
• Resolve held revenue by processing stop holds and communicating with payers.

Skills

DME billing knowledge

HIPAA compliance

Communication skills

Detail oriented

Keyboarding

Education

HS diploma/GED

Tools

Brightree

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

DME Documentation Specialist

Full Time Clerical RMTUS, Remote, US

ACU-Serve delivers billing solutions to HME (Home Medical Equipment) providers, giving them the freedom to grow their business while collecting more, faster. ACU-Serve has helped HME businesses cut through the complexity of an ever-transitioning billing process while becoming a trusted partner for continued growth. Clients routinely show faster collections, higher revenue and dramatically reduced management and staffing problems. ACU-Serve incorporates HME workflow, Medicare, Medicaid and Private Payer knowledge, and billing and collections experts into a single service on an Internet-based technology platform. The result is faster payments, higher revenue collection rates, and less management and staffing headaches. Unlike traditional billing service models, ACU-Serve provides HME clients with a new level of control, flexibility, information access, and billing expertise. ACU-Serve functions as an integral part of the HME office staff, not a remote third party billing vendor.

Position Summary:

The DME Documentation Specialist must be knowledgeable of all equipment and supplies provided by Home Medical and uphold its standard for excellence. Responsible for processing orders for various medical equipment. Experience in durable medical field preferred specifically insurance and medical terminology. Responsible for competently and efficiently performing all tasks relative to the order intake process in a friendly, professional manner.

Responsibilities:

• Collects, reviews and requests medical documentation required to support medical necessity to submit for Prior Authorization.


• Submits and maintains prior authorizations and all certificates of medical necessity (CMN)


• Requests documentation to support medical necessity and ongoing need for various durable


• Medical equipment items including and not limited to oxygen and sleep therapy.


• Creates initial, revised and recertification certificates of medical necessity within various DME billing software systems.


• Reviews incoming CMN’s and medical records for accuracy.


• Reviews and completes stop hold reports to resolve and release held revenue to various payers.


• Knowledgeable of Medicare, Medicaid and other insurance companies’ rules regarding CMN’s, detailed written orders and prior authorizations.


• Ability to converse with clinicians and office staff to follow up on outstanding requests and to describe information required.

Qualifications:

• Minimum of 1 year of experience in durable medical billing requirements; understanding Durable Medical Equipment intake processes including insurance verification, and Prior


• Authorization Requests. Experience working in DME billing platform – Brightree.


• Knowledge of requirements for Medicare, Medicaid, and Commercial payers as for what qualifies a patient for coverage of prescribed equipment.


• HS diploma/GED.


• Knowledge of documentation requirements for multiple HCPCs


• Strong computer skills including MS Word, Excel and strong keyboarding skills.


• Proven ability to use formal business language to communicate effectively in written form including spelling and punctuation.


• Strong attention to detail.


• Task oriented while performing in a fast-paced environment.


• Results-oriented self-starter with a can-do attitude, a sense of urgency and ability to complete tasks in a timely manner.


• Proven ability to review current processes and procedures and suggest process improvements or solutions.


• Able to work with others with diverse personalities.


• Good problem-solving skills including managing crisis situations calmly and professionally as well as the ability to maintain confidential patient, financial and company information, following HIPAA guidelines.

ACU-Serve is an equal opportunity employer and is committed to providing a workplace that is free of discrimination of all types and promotes diversity, inclusion, and respect. We prohibit discrimination and harassment of any kind based on race, color, sex, gender, religion, creed, sexual orientation, national origin, age, disability, genetic information, pregnancy, veteran status, or any other protected characteristic as outlined by federal, state, or local laws. This policy applies to all employment practices within our organization. ACU-Serve makes hiring decisions based solely on qualifications, merit, and business needs at the time.