Qualification Specialist

Norco • Meridian, ID

1d

About The Position

Norco is seeking a Qualification Specialist to verify that required medical documentation is received, accurate, and gathered efficiently and in a timely manner for all orders. The role works with insurance requirements and medical records to support coverage and authorization for equipment before delivery whenever possible. The position also involves communicating with customers about their expected financial responsibilities and staying current on industry updates and Medicare changes.

Requirements

• High school graduate or equivalent.
• Accurately enter data into a computer and acquire working knowledge of software applications applicable to the position.
• Perform basic mathematical calculations.
• Perform tasks requiring manual dexterity, such as processing paperwork, filing, stapling, and sorting.
• Excellent problem-solving skills.
• Excellent verbal and written communication skills.
• Ability to work well with a team.

Responsibilities

• Know the documentation requirements for payers and product categories for which Norco provides services.
• Know insurance company policy manuals, fee schedules, and contracts.
• Perform insurance verification.
• Gather medical documentation required to meet specific insurance company guidelines.
• Submit and obtain insurance prior authorizations for equipment through methods such as fax, online portals, or mail before delivery whenever possible.
• Review documentation to ensure pay coverage criteria are met when prior authorization cannot be obtained from the insurance company.
• Follow up with therapists and physicians when DWOs, DPDs, chart notes, and LMNs are not received according to Norco protocol.
• Communicate customers’ expected financial responsibilities.
• Stay abreast of industry updates and Medicare changes.
• Perform other tasks as assigned or necessary.

Benefits

• Employee Stock Ownership Plan (ESOP)
• Health, vision, and dental insurance
• Health Savings Account (HSA)
• Medical and dependent care Flexible Spending Accounts (FSA)
• Life insurance provided at no cost to the employee
• Supplemental accident, disease, and life insurance options
• Employee tuition reimbursement
• 401(k) with employer matching
• Employee discount on products sold by Norco

What This Job Offers

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