Clinical Order Management Specialist

Sound Physicians • Dallas, TX

4d • Onsite

About The Position

The Clinical Order Management Specialist is responsible for performing all tasks and communication related to the intake and processing of prescriptions and/or physician orders, as well as patient information concerning durable medical equipment. This role regularly communicates with patients, health care providers, Team Members, Health Insurance (payor) representatives, and referral sources. The Clinical Order Management Specialist coordinates with DME vendors, physicians, and applicable internal/external personnel regarding medical records and information needed to process orders that are placed by physicians. They confirm medical records meet medical necessity based on applicable insurance guidelines and promptly follow up on patient referrals, physician prescriptions, and/or physician work orders.

Requirements

• Medical Assistant Certification
• Knowledge of medical terminology
• High School Diploma
• 2-3 years as a certified medical assistant within a clinic or hospital setting
• Extensive organizational and task management experience
• Electronic Medical Records experience

Responsibilities

• Assisting with appeals for Prior Authorization denials
• Placing orders for Durable Medical Equipment, Diagnostic Imaging and Specialty Drugs
• Reviewing “Delivery Tickets” to confirm they were completed accurately and signed
• Performing data entry to supplement orders including patient demographics, prescribing physician’s information, insurance payor information, HCPCS procedure codes, ICD-10 diagnosis codes, etc.
• Regularly contacting and communicating with Team Members, insurance companies, vendors, sales representatives, doctor’s offices, practitioners, clearinghouses, billers, and other applicable companies and associates, sending updates on prior authorizations, claims, patient benefits, orders, and other information as appropriate
• Acting as an expert on insurance coverage with all vendors
• Answering incoming phone calls to the office and routing messages accordingly
• Performing detailed notetaking with high accuracy on pertinent information
• Utilizing Adobe Acrobat Pro to create and edit PDF files: insert/move/delete pages; edit/add/redact text; save meta data, create templates, export/import data through plugin, etc.
• Consistently following up with patients to confirm patient satisfaction
• Accurately completing forms/applications and sending out to applicable destination
• Exercising patience and empathy when communicating with patients and customers
• Being aware of and adapting to changes in medical regulations and processes

Benefits

• Medical insurance
• Dental insurance
• Vision insurance
• Health care and dependent care flexible spending account
• 401(k) retirement savings plan with a company match
• Paid time off (PTO) begins accruing immediately upon start date at a rate of 15 days per year, in accordance with Sound's PTO policy
• Ten company-paid holidays per year

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED