DME Medical Records
About The Position
Northern Pharmacy & Medical Equipment is seeking a detail-driven, motivated DME Medical Records Review Specialist to help ensure patients receive the equipment and supplies they need. The position focuses on documentation accuracy, regulatory compliance, and reimbursement integrity. The specialist reviews medical records to verify that required documentation supports medical necessity and insurance requirements, and works with healthcare professionals to resolve documentation issues and prevent delays in patient care. This is an in-person position in Baltimore, Maryland, in a collaborative, fast-paced healthcare operations environment. The company describes its team culture as supportive and offers opportunities to develop industry expertise.
Requirements
- High school diploma or GED.
- At least 1 year of experience in DME, medical records review, or a related healthcare role.
- Strong understanding of medical terminology.
- Knowledge of Medicare, Medicaid, and commercial insurance documentation requirements.
- Familiarity with DX, CPT, and HCPCS coding.
- Excellent communication and organizational skills.
- Strong computer and data entry skills.
- Ability to prioritize tasks and work efficiently in a fast-paced environment.
- Detail-oriented with strong problem-solving abilities.
Nice To Haves
- Associate degree or related college coursework.
- Experience using Brightree software.
- Previous experience in insurance verification or medical billing.
- DME compliance, audit, or documentation review experience.
Responsibilities
- Review and audit medical records to confirm documentation supports medical necessity for durable medical equipment and supplies.
- Ensure compliance with Medicare, Medicaid, and commercial insurance guidelines.
- Identify missing or incomplete documentation and follow up with physicians, clinicians, and office staff.
- Secure required documentation to support accurate billing and timely reimbursement.
- Enter and maintain accurate patient data in EMR and billing systems.
- Review documentation for initial qualification and continued medical need for DME equipment.
- Interpret and apply DX, CPT, and HCPCS codes appropriately.
- Troubleshoot documentation issues and independently resolve complex cases.
- Maintain compliance with HIPAA and regulatory standards.
- Communicate professionally with internal teams, referral sources, and healthcare providers.
- Support operational efficiency through consistent attendance and reliability.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
