Healthcare Inside Sales Specialist — DME & Referrals

AdaptHealth, LLC; Boca Raton (FL); On-site; USD 45,000 - 70,000; Full time

Job summary

AdaptHealth is seeking an Inside Sales Specialist in Boca Raton to ensure continuity among patients, clinics, and home care, driving sales and new patient referrals while coordinating with insurers to secure coverage. The role emphasizes timely order processing, authorization acquisition, and case documentation.

You will support marketing efforts, educate patients and providers, and manage complex orders and re-verification tasks to maximize patient satisfaction and service delivery.

Qualifications

• High School Diploma required; Associate Degree from an accredited college is preferred.
• One (1) year work related in health care, administrative, insurance, customer services, or management regardless of industry
• B2B or B2C Sales preferred

Responsibilities

• Effectively working through a high volume of outbound calls in a fast-paced environment
• Generates a steady stream of referrals through researching various sales and marketing sources, selling all offered services
• Develop long term relationships with patients, families, referrals, clinics, etc. through cold calling, problem solving with insurance companies, follow-up, and integrity
• Partner with Marketing department to develop or enhance educational literature for patients, families, physicians, clinics, etc.
• Obtains all required information and medical documentation to ensure complete, accurate and timely processing of supply program orders. Validate codes and fees to assure there is coverage under the patient’s policy
• Obtain Insurance authorizations when required by the Insurance and obtains physician order signatures as needed
• Discusses coverage guidelines with patients/referral sources and arranges for payment of non-covered items. Suggests alternative equipment as warranted based on reimbursement limitations
• Contact patients to explain benefits and financial responsibility for services and assist them with questions regarding their insurance coverage
• Contact referral sources and patients to discuss any problems or delays encountered during insurance verification
• Assures that diagnoses and disease-state warrant the need for prescribed durable medical equipment (DME) from a reimbursement standpoint. Suggests additional equipment if warranted based on diagnoses or makes appropriate recommendations
• Understands issues related to the most cost-effective delivery method for DME ordered
• Maintains working knowledge base regarding billing, documentation, and reimbursement guidelines/ issues, including but not limited to Medicare, Medicaid, Other Third Party, and contracted payers
• Assist patients and referrals in finding an alternative provider if service is not covered by insurance
• Prioritize urgent or emergency orders
• Validate and Log CMNs and PARs as needed
• Acts as a resource to all external customers to facilitate resolution of AH patient issues in coordination with members of the operational teams within AH to assure optimal patient and referral source outcomes
• Acts as a resource for referral source staff regarding Medicare, Medicaid and private insurance documentation and reimbursement guidelines related to DME/RT equipment and services
• Identifies programs or initiatives that potentially could increase company revenues, decrease costs, and/or increase customer satisfaction
• Knows when to appropriately use best judgment with patients/referral sources during conflicts
• Contributes to creative problem-solving and decision-making within the branch marketing team to achieve marketing/sales goals
• Job Title: Inside Sales Specialist FLSA Classification: Non-Exempt
• Expresses confidence in ability to diagnose, develop and carry out solutions to customer complaints
• Makes appropriate service-related decisions by reviewing all relevant medical information and facts, exploring all medical alternatives
• Knows when to appropriately use consensus and/or independent decision-making styles
• Identifies and clearly communicates to sales and operations the needs of hospital and physician referral sources
• Promotes teamwork within branch sales and operational teams by adapting to necessary changes in operational needs
• Utilizes team/company communication systems to report and process requested information
• Shares information and expertise with colleagues to enable them to carry out their role more effectively
• Participates in team meetings as requested

Skills

Verbal comms

Written comms

Presentation

Customer service

Product knowledge

Sales motivation

Independent work

Teamwork

Analytical skills

Problem solving

Multitasking

Education

High School Diploma

Associate Degree preferred

Tools

Microsoft Office

Job description

AdaptHealth is seeking an Inside Sales Specialist in Boca Raton to ensure continuity among patients, clinics, and home care, driving sales and new patient referrals while coordinating with insurers to secure coverage. The role emphasizes timely order processing, authorization acquisition, and case documentation.

You will support marketing efforts, educate patients and providers, and manage complex orders and re-verification tasks to maximize patient satisfaction and service delivery.