Senior DME Referral Care Coordinator

Paradigm; Tampa (FL); Remote; USD 70,000 - 95,000; Full time

Job summary

Paradigm is a remote-friendly, full-time employer seeking a Senior DME Referral Care Coordinator to manage the DME referral process end-to-end for injured workers and complex cases.

You will coordinate with vendors, providers, payors, and internal teams to ensure timely delivery, accurate documentation, and compliant invoicing while supporting onboarding and process improvements.

Qualifications

• Minimum 35 years of experience in DME coordination, referral management, or related healthcare operations.
• Strong knowledge of Durable Medical Equipment processes, authorizations, and vendor coordination.
• Proficiency with healthcare systems, referral platforms, and Microsoft Office applications.
• Excellent organizational, prioritization, and multi-tasking skills.
• Strong written and verbal communication skills with a customer service focus.
• Workers' Compensation or Care at Home experience.

Responsibilities

• Receive, review, and process Complex DME referrals from internal and external referral sources, ensuring accuracy and completeness prior to fulfillment.
• Coordinate with payors to obtain required authorizations prior to DME delivery.
• Work closely with DME vendors, providers, injured workers/patients, and referral sources to ensure appropriate equipment is delivered within required timeframes.
• Provide proactive status updates and delivery confirmations to all stakeholders.
• Manage complex, high risk, or escalated DME cases requiring advanced problem solving and coordination.
• Ensure accurate pricing and documentation are provided to Billing to support timely and correct invoicing.
• Maintain complete and compliant documentation, including prescriptions, clinical notes, authorizations, and invoices, in accordance with company policy and regulatory requirements.
• Assist with reconciliation of unmatched claims or billing discrepancies as needed.

Skills

DME coordination

Vendor coordination

Customer service

Problem solving

Attention to detail

Communication skills

Education

High school diploma

Associate degree or higher

Tools

Microsoft Office

Job description

Paradigm is an accountable specialty care management organization focused on improving the lives of people with complex injuries and diagnoses. The company has been a pioneer in value-based care since 1991 and has an exceptional track record of generating the very best outcomes for patients, payers, and providers. Deep clinical expertise is the foundation for every part of Paradigm's business: risk-based clinical solutions, case management, specialty networks, home health, shared decision support, and payment integrity programs.

We’re proud to be recognized—again! For the fourth year in a row, we've been certified by Great Place to Work®, and for the third consecutive year, we've earned a spot on Fortune's Best Workplaces in Health Care™ list. These honors reflect our unwavering commitment to fostering a positive, inclusive, and employee-centric culture where people thrive.

Watch this short video for a brief introduction to Paradigm.

Paradigm is seeking a Senior DME Referral Care Coordinator to coordinate the timely, accurate, and compliant delivery of durable medical equipment for injured workers and patients with complex needs. In this fully remote role, you will manage the DME referral process from intake and authorization through delivery and billing support, working closely with vendors, providers, payors, and internal teams to resolve barriers and keep services on track.

As a subject matter expert, you will handle complex or escalated cases requiring advanced problem-solving and coordination while serving as a resource for team members. This role also supports onboarding, training, and process improvements that enhance service quality, improve turnaround times, and create an exceptional customer experience.

This is a full-time, fully remote position. Work hours are Monday through Friday, either 9:30 a.m.6:00 p.m. EST or 12 p.m.8:30 p.m. EST.

Responsibilities:

• Receive, review, and process Complex DME referrals from internal and external referral sources, ensuring accuracy and completeness prior to fulfillment.
• Coordinate with payors to obtain required authorizations prior to DME delivery.
• Work closely with DME vendors, providers, injured workers/patients, and referral sources to ensure appropriate equipment is delivered within required timeframes.
• Provide proactive status updates and delivery confirmations to all stakeholders.
• Manage complex, high risk, or escalated DME cases requiring advanced problem solving and coordination.
• Ensure accurate pricing and documentation are provided to Billing to support timely and correct invoicing.
• Maintain complete and compliant documentation, including prescriptions, clinical notes, authorizations, and invoices, in accordance with company policy and regulatory requirements.
• Assist with reconciliation of unmatched claims or billing discrepancies as needed.

Quality, Compliance & Customer Experience.

• Ensure compliance with payer guidelines, regulatory requirements, and internal policies related to DME and Protected Health Information (PHI).
• Demonstrates a customer-first mindset by developing a broad and deep (where appropriate) understanding of Paradigm organization, products, operations, and customers. Prioritizes collaboration to meet customer needs and expectations and takes personal accountability for service quality.
• Provide exceptional customer service, addressing questions, concerns, and complaints in a timely and professional manner.
• Maintain reliable and predictable attendance during scheduled work hours.
• Follow up with injured workers/patients and referral sources to ensure satisfaction and resolve service issues.
• Serve as a resource and mentor to DME Coordinators and Intake staff, providing guidance on workflows, systems, and complex cases.
• Assist leadership with onboarding and training of new team members.
• Support process improvement initiatives, documentation updates, and special projects related to DME operations.
• Identify opportunities to improve turnaround times, vendor performance, and service quality.
• Maintain reliable and predictable attendance during scheduled work hours.
• Utilizes AI tools to support day-to-day tasks, improve efficiency, and enhance output quality. Adopts new technologies as trained and applies them in alignment with established processes and guidelines.
• Responsible for complying with Paradigm Information Security requirements and policies, for safeguarding Paradigm or Paradigm related passwords, and for notifying Paradigm of any Information Security incidents per policy SEC 10-12 Information Security Incident Management.

Qualifications:

• High school diploma or equivalent required; associate degree or higher preferred.
• Minimum 35 years of experience in DME coordination, referral management, or related healthcare operations.
• Strong knowledge of Durable Medical Equipment processes, authorizations, and vendor coordination.
• Strong knowledge of medical terminology, healthcare documentation, and complex injuries.
• Proficiency with healthcare systems, referral platforms, and Microsoft Office applications.
• Excellent organizational, prioritization, and multi-tasking skills.
• Strong written and verbal communication skills with a customer service focus.
• Workers' Compensation or Care at Home experience.
• Prior experience handling escalated or complex DME cases.
• Experience mentoring or supporting junior staff.
• Familiarity with DME billing workflows and payer requirements.
• Attention to detail and accuracy
• Customer Centric Mindset
• Problem solving and critical thinking
• Collaboration and teamwork
• Confidentiality and professionalism

Other details

PI288276655