DME Documentation Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Process orders for a variety of durable medical equipment.

• Collect, review, and request medical documentation necessary to substantiate medical necessity for Prior Authorization.

• Submit and manage prior authorizations and certificates of medical necessity (CMNs).

• Request documentation that supports medical necessity and the ongoing need for durable medical equipment, such as oxygen and sleep therapy.

• Generate initial, revised, and recertification CMNs within DME billing software systems.

• Examine incoming CMNs and medical records for precision.

• Review and finalize stop-hold reports to address and release held revenue to payers.

• Implement Medicare, Medicaid, and other insurance regulations concerning CMNs, detailed written orders, and prior authorizations.

• Liaise with clinicians and office personnel to follow up on outstanding requests and clarify required information.

⛳️ Requirements

• At least 1 year of experience in durable medical billing requirements.

• Familiarity with Durable Medical Equipment intake processes, including insurance verification and Prior Authorization Requests.

• Experience using the Brightree DME billing platform.

• Knowledge of Medicare, Medicaid, and commercial payer standards for coverage of prescribed equipment.

• High school diploma or GED.

• Understanding of documentation requirements for multiple HCPCs.

• Proficient computer skills, including MS Word and Excel.

• Strong keyboarding abilities.

• Capability to utilize formal business language effectively in written communication, ensuring correct spelling and punctuation.

• Exceptional attention to detail.

• Ability to thrive in a fast-paced, task-driven environment.

• Results-oriented self-starter with a sense of urgency and the capability to complete tasks promptly.

• Skill in reviewing processes and procedures and proposing improvements or solutions.

• Capacity to collaborate with individuals of diverse personalities.

• Problem-solving abilities, including the calm and professional management of crisis situations.

• Commitment to maintaining confidential patient, financial, and company information in accordance with HIPAA guidelines.

🏝️ Benefits

• Equal opportunity employment.

• Workplace free of discrimination and harassment.

• Commitment to diversity, inclusion, and respect in the workplace.