DME Medical Records
About The Position
Northern Pharmacy & Medical Equipment is looking for a detail-driven and motivated DME Medical Records Review Specialist to join our growing team. In this role, you will play a vital part in ensuring patients receive the equipment and supplies they need while maintaining the highest standards of documentation accuracy, regulatory compliance, and reimbursement integrity. If you enjoy solving problems, working with healthcare professionals, and being part of a fast-paced team that supports patient care behind the scenes, this is an excellent opportunity to grow your career in healthcare operations.
Requirements
- High School Diploma or GED
- Minimum 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
- Reviewing and auditing medical records to confirm documentation supports medical necessity for durable medical equipment and supplies
- Ensuring compliance with Medicare, Medicaid, and commercial insurance guidelines
- Identifying missing or incomplete documentation and proactively following up with physicians, clinicians, and office staff
- Securing required documentation to support accurate billing and timely reimbursement
- Entering and maintaining accurate patient data in EMR and billing systems
- Reviewing documentation for initial qualification and continued medical need for DME equipment
- Interpreting and applying DX, CPT, and HCPCS codes appropriately
- Troubleshooting documentation issues and independently resolving complex cases
- Maintaining strict compliance with HIPAA and regulatory standards
- Communicating professionally with internal teams, referral sources, and healthcare providers
- Supporting operational efficiency by maintaining 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
