Durable Medical Equipment Specialist/Customer Service

AllCare Medical Supply Corp; Millbury (MA); In loco; USD 30.000 - 41.000; Tempo pieno

Descrizione del lavoro

AllCare Medical Supply Corp. seeks a detail-oriented DME Specialist to join our DME team. You will support patients by handling insurance verifications, prior authorizations, and documentation, ensuring timely care and accurate coding.

You will coordinate with providers, obtain necessary records, and educate patients on insurance requirements and product options, maintaining a patient-centered approach and high-quality service.

Competenze

• Proficient in CPT coding, ICD-9/ICD-10 terminology.
• Experience with HIPAA regulations and patient confidentiality.
• Strong insurance verification and authorization experience preferred.
• Excellent written and verbal communication; detail-oriented.

Mansioni

• Answer incoming and make outbound calls regarding products, orders, insurance coverage, and account status.
• Provide exceptional customer service while maintaining a patient-centered approach.
• Process new orders, reorder supplies, and update accounts accurately.
• Educate patients on products, insurance requirements, and documentation for orders.
• Coordinate with providers to obtain prescriptions and medical records.
• Assist with authorization updates and insurance communications.
• Review and process prior authorization requests in line with insurance guidelines.
• Apply CPT/ICD coding correctly in authorization submissions.

Conoscenze

CPT coding

ICD coding (ICD-9/ICD-10)

HIPAA regulations

Insurance verification

Communication skills

Organizational skills

Descrizione del lavoro

We are seeking a detail-oriented and knowledgeable Durable Medical Equipment Specialist to join our Durable Medical Equipment (DME) team. This role is essential in ensuring that patients receive timely care, approval for necessary medical supplies and services, and knowledge of our product offering. The ideal candidate will possess a strong understanding of managed care, medical terminology, and coding practices, along with excellent communication skills to navigate the complexities of insurance verification and authorization processes.

Responsibilities

• Answer incoming phone calls and place outbound calls to assist patients, caregivers, healthcare providers, and referral sources with inquiries regarding products, orders, order status, insurance coverage, and account status.
• Provide exceptional customer service by resolving concerns promptly and professionally while maintaining a patient-centered approach.
• Process new orders, supply reorders, and account updates accurately and efficiently.
• Educate patients on available products, insurance requirements, and documentation needed to fulfill orders.
• Coordinate with referral sources and healthcare providers to obtain prescriptions, medical records, and supporting documentation.
• Assist with outbound calls to patients, providers, and insurance companies regarding order status, documentation needs, and authorization updates.
• Review and process prior authorization requests for medical services, ensuring compliance with insurance guidelines
• Utilize knowledge of CPT coding, ICD-9, and ICD-10 to ensure correct coding practices in authorization submissions

Requirements

• Experience in a DME setting is highly preferred.
• Familiarity with HIPAA regulations and patient confidentiality practices.
• Proficient in CPT coding, ICD coding (ICD-9 and ICD-10), and medical terminology.
• Strong organizational skills with attention to detail in managing medical records and documentation.
• Ability to perform insurance verification efficiently and accurately.
• Strong verbal and written communication skills
• Previous experience in a Durable Medical Equipment office is a plus but not required.
• Excellent communication skills, both written and verbal, to interact effectively with various stakeholders.
• A commitment to providing high-quality patient care through thorough authorization processes.