DME Claims Specialist- Health First Medical Equipment Administration

Health First•Melbourne, FL

58d

About The Position

Customer Service intake position responsible for processing new DME orders from all referral sources. Associate will determine medical necessity and deliver appropriate and accurate information to all necessary departments to facilitate billing in compliance with regulatory and department processes. Associate will follow-up with referral sources and customers while delivering exceptional service.

Requirements

High school diploma or GED
6 months of Customer Service experience
Successful completion of Level II background screening
Technology - Microsoft office, such as Outlook, Word, Excel, PowerPoint and relevant systems and applications relevant to role and expected duties
Customer Focus - performing all duties with the customer in mind
Communications - written, oral, verbal, and listening. Asking necessary questions in a non-threateningmanner to obtain customer information and/or to achieve desired outcome.
Problem Solving - use facts, information from customer, regulations, policies, and procedures to resolve situations and meet goals and objectives
Decision Making - within scope of role and communicate to appropriate parties
Adaptable - willing to perform other duties as assigned or fulfil schedules as needed

Nice To Haves

One year experience in healthcare environment
Industry Knowledge - Working knowledge of medical insurance and medical terminology

Responsibilities

Receive and process referrals from Hospitals, Provider offices, Rehab's, etc., and maintain frequent communication about delivery of setups.
Review medical record for appropriate documentation of diagnosis, notes, and equipment ordered. Verify insurance benefits, copays and same/similar and review with customer all out of pocket expenses.
Respond to customer inquiries or equipment orders by researching, understanding, and documenting the account. Create appropriate delivery documentation as necessary.
Assist customers in a caring and knowledgeable manner, representing the organization as a skilled health care professional.
Create billing documents needed per insurance guidelines as necessary and follow-up on those that are outstanding in a timely manner.
Work reports such as held claims, open orders daily to ensure timely billing and follow-up on outstanding documentation.
Coordinate delivery of equipment with DME Technicians and DME Supervisor.
Contribute to a collaborative culture and positive work environment.
Assist in over-the-counter sales and/or rentals, identifying needed equipment and/or supplies and instruct customers in the safe and proper use of equipment and supplies, including maintenance.
Participate in store inventory as necessary. Ensure retail area is stocked with equipment when assigned to that workspace. Balance point of sale terminal cash drawers daily when assigned to retail workspace