Order Specialist | Home Medical Equipment

Monument Health•Rapid City, SD

2d•$18 - $23

About The Position

The Order Specialist works with customer accounts to review orders for complete documentation and accurate insurance processing. The position validates database records, customer documents, and insurance information for regulatory compliance, maintains accurate records of customer information and products, and supports an effective customer experience. The role is with Monument Health Home Plus in Rapid City, South Dakota, and is scheduled for 40 hours per week. Responsibilities include creating and updating customer profiles, processing sales orders and purchase requests for prescribed medical equipment, reviewing insurance claims and medical records for required documentation, and resolving claim issues and order concerns. The Order Specialist also coordinates deliveries, assists customers by phone and in person, supports retail sales and product education, manages inventory and the retail area, and processes point-of-service payments and daily cash reconciliation.

Requirements

High school diploma or GED equivalent.
Ability to work assigned schedules and hours as determined by the department.

Nice To Haves

At least 3 years of Home Medical Equipment experience.
At least 3 years of healthcare experience.
At least 3 years of customer service experience.

Responsibilities

Create customer profiles for new customers and verify or update customer demographic and insurance information in the system of record.
Generate sales orders and purchase requests for medical equipment prescribed to patients.
Apply knowledge of third-party payers, including Medicare, Medicaid, VA, Tricare/UHC, and commercial payers, to support compliance and accurate reimbursement.
Analyze insurance claims to confirm required documentation is obtained and meets regulatory insurance standards.
Evaluate and process outstanding orders, follow up with customers on order status, and resolve customer requests or issues.
Work with insurance providers to resolve claim issues; research and rework claim kickbacks, rejections, and denials.
Review medical records for consistency with insurance regulations and request additional documentation from providers according to payer and billing requirements.
Coordinate deliveries with technicians and customers; assist with preparing and packaging items for delivery or mailing as needed.
Answer incoming phone calls and maintain communication between departments and customers.
Assist walk-in customers with retail sales and supply orders; provide DME product education and fitting as needed.
Manage product inventory and maintain an organized retail area.
Perform point-of-service collections, including prepayments, outstanding balances, copayments, and coinsurance; reconcile the cash drawer daily and provide basic account reconciliation to patients.
Perform other duties as assigned.