RRT Case Coordinator | FT | Days | Home Health Offices | Bartlett

Methodist Le Bonheur Healthcare; United States; On-site; USD 60,000 - 85,000; Full time

Job summary

Methodist Le Bonheur Healthcare is seeking a Respiratory Therapist to coordinate high-technology home medical equipment and manage referrals, insurance verifications, and pre-certifications. You will work with physicians, patients, and payors to ensure timely delivery and accurate documentation.

The role involves collaboration with the interdisciplinary team, maintaining accurate records, and pursuing opportunities to improve patient care and departmental efficiency.

Qualifications

• Requires an Associate's Degree in Respiratory Care.
• Preferred technical degree or diploma in Respiratory Care.

Responsibilities

• Receives and processes high tech respiratory referrals and coordinates related information.
• Verifies insurance coverage and handles pre-certification/verification of benefits.
• Obtains prior authorizations or certificates of medical necessity when required by payors.
• Assesses opportunities to reduce fragmentation in delivery and utilization of equipment and supplies.
• Communicates with customer, physician and payor sources regarding equipment needs and guidelines.
• Collaborates with interdisciplinary team on utilization and payor considerations.
• Creates master files in the computer system for recurring sales and usage with payor guidance.
• Interacts with payors for cases needing advanced clinical knowledge and detailed customer needs.
• Demonstrates initiative for self-improvement and serves as a resource for the HME team.
• Maintains strong customer skills and contributes to a positive team environment.

Skills

Customer service

Problem solving

Medical records interpretation

Communication skills

Independent judgement

Prioritization

Multitasking

Stress management

Education

Associates Degree Respiratory Care

Technical Degree or Diploma Respiratory Care

Job description

If you are looking to make an impact on a meaningful scale, come join us as we embrace the Power of One!

We strive to be an employer of choice and establish a reputation for being a talent rich organization where Associates can grow their career caring for others. For over a century, we’ve served the health care needs of the people of Memphis and the Mid-South.

Responsible for the coordination and utilization of equipment and supplies of high technology, home medical equipment customers, maintaining flow of patient information to all departments, including physician orders, verification of insurance status and coordination of deliveries. Models appropriate behavior as exemplified in MLH Mission, Vision and Values.

Working at MLH means carrying the mission forward of caring for our community and impacting the lives of patients in every way through compassion, a deliberate focus on service expectations and a consistent thriving for excellence.

A Brief Overview

Responsible for the coordination and utilization of equipment and supplies of high technology, home medical equipment customers, maintaining flow of patient information to all departments, including physician orders, verification of insurance status and coordination of deliveries. Models appropriate behavior as exemplified in MLH Mission, Vision and Values.

What you will do

• Receives and processes high tech respiratory referrals.
• Verifies customers’ insurance coverage. Provides clinical and demographic information for the purpose of pre-certification/verification of benefits. May negotiate pricing for various services, as determined.
• Obtains a prior authorization (PA) and/or a certificate of medical necessity (CMN) when required by insurance company or payor.
• Assesses for opportunities to decrease fragmentation in delivery and utilization of equipment and supplies, being cognizant of the reimbursement guidelines for each payor.
• Assess all high tech respiratory equipment and supply needs communicating with customer, physician, and payor source as appropriate.
• Collaborates with appropriate members of the interdisciplinary team (i.e. customer service, respiratory care and operations) regarding utilization of equipment and supplies.
• Creates master file in computer system for reoccurring sales for individual customers, communicating appropriate usage and payor guidelines.
• Interacts with payors for cases requiring advanced clinical knowledge and detailed knowledge of customer needs.
• Demonstrates the initiative in identifying and pursuing opportunities for self-improvement and enhancement of professional competency; serves as a resource for other members of the HME department.
• Demonstrates effective customer skills, promotes a positive work environment, and contributes to the overall team effort.
• Performs other job functions as assigned or requested.

Education/Formal Training Requirements

• Required - Associates Degree Respiratory Care
• Preferred - Technical Degree or Diploma Respiratory Care

Work Experience Requirements

• Required - Respiratory Therapist 3-5 years
• Preferred - Home medical equipment 1-3 years

Licenses and Certifications Requirements

• Required - BASIC LIFE SUPPORT - American Heart Association
• Required - Registered Respiratory Therapist - National - National Board for Respiratory Care
• Required - Registered Respiratory Therapist - Tennessee - Tennessee Board of Respiratory Care
• Preferred - Registered Respiratory Therapist - Mississippi - Mississippi State Department of Health
• Preferred - Registered Respiratory Therapist - Arkansas - Arkansas State Medical Board

Knowledge, Skills and Abilities

• Demonstrates customer service skills.
• Ability to apply problem solving techniques.
• Ability to assess and interpret medical records to a degree that would support independent work.
• Possesses excellent communication skills.
• Ability to work without close supervision and to exercise independent judgement, set priorities, coordinate multiple tasks, maintain workflow, and prepare complex written materials.
• Ability to handle emotional or stressful situations in relation to patients in acute distress, medical crisis, physicians, or families of dying patients.

Supervision Provided by this Position

• There are no supervisory or lead responsibilities assigned to this position.

Physical Demands

• The physical activities of this position may include climbing, pushing, standing, hearing, walking, reaching, grasping, kneeling, stooping, and repetitive motion.
• Must have good balance and coordination.
• The physical requirements of this position are: medium work - exerting up to 50 lbs. of force occasionally and/or up to 25 lbs. of force frequently.
• The Associate is required to have close visual acuity including color, depth perception, and field of vision to perform an activity, such as assessing patients, preparing and analyzing data and figures; transcribing; viewing a computer terminal; or extensive reading.
• Frequent invasive and non-invasive patient contact.