Funding Specialist Lead

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

📋 Description

• Collaborate with the Division Funding Director, Funding Manager, Funding Supervisor, Branch Manager, Rehabilitation Technology Suppliers, and office support staff.

• Conduct thorough reviews of orders for accuracy and provide education to Funding Specialists when discrepancies are found.

• Cultivate and uphold expertise in durable medical equipment, company policies and procedures, as well as insurance eligibility and reimbursement guidelines.

• Ensure adherence to company policies and procedures.

• Oversee the transaction cycle from Coding and Pricing Complete to Documentation Complete.

• Assist Funding Specialists during PTO, absences, open positions, and other operational demands.

• Engage with referral sources, physicians, therapists, RTSs, clients, and both internal and external customers to obtain necessary documentation.

• Adhere to documentation collection frequency and escalation protocols.

• Request, compile, review, and confirm funding-package documentation, prescriptions, Letters of Medical Necessity, RTS evaluations, price lists, and required forms.

• Verify insurance coverage and convey benefits, coverage details, and financial responsibilities to clients.

• Maintain communication with clients and guide them through hardship processes when applicable.

• Coordinate Funding Action Required tasks and work collaboratively with other funding teams.

• Research payer documentation requirements and update the UPD accordingly.

• Identify and resolve issues and concerns related to the funding process.

• Execute additional funding tasks, including Coding and Pricing, Submissions, Authorization collection, PPQA, and Delivery Verifications.

• Provide direction, instructions, and guidance to team members.

• Document best practices, pinpoint training opportunities, and address UPD discrepancies or updates.

• Facilitate collaboration and problem-solving efforts.

• Inspire team members and acknowledge their achievements.

• Assist with customer complaints, billing inquiries, payer concerns, and correspondence.

• Support performance monitoring and evaluation initiatives.

• Communicate team progress, task completion, and directives to management.

• Conduct routine audits to identify coaching opportunities and ensure high performance among staff.

• Aid in new business acquisitions and temporary branch processing requirements.

• Perform other related duties and special projects as assigned.

⛳️ Requirements

• A minimum of 3 years of experience in Durable Medical Equipment and/or Complex Rehab Technology.

• Preferred experience covering all facets of a Funding Specialist’s role, including handling Repairs and Non-Repairs.

• In-depth knowledge of processes and insurance guidelines necessary for securing funding for Durable Medical Equipment and/or Complex Rehab Technology.

• Comprehensive understanding of insurance verification for DME.

• Familiarity with applications like Mobility Advisor or data management systems.

• Exceptional interpersonal skills, along with strong communication abilities.

• Proven leadership capabilities.

• Strong team collaboration skills.

• Excellent organizational abilities with a keen attention to detail.

• A customer service-oriented mindset.

• Proficient in computer and technology applications.

• Knowledge of Microsoft Office applications, including Outlook and PowerPoint.

• Experience with Excel, involving spreadsheets and formulas, as well as Outlook email.

• Capability to manage and develop team members remotely.

• Ability to read, analyze, and interpret general business reports, technical procedures, work instructions, and governmental regulations.

• Proficiency in writing reports, business correspondence, and developing training materials.

• Ability to effectively present information and answer questions from various staff members.

• Basic understanding of and eagerness to learn and adopt professional and industry standards.

• Must comply with the work-from-home policy and requirements.

🏝️ Benefits

• 401k

• Company-paid Long Term Disability

• Tuition reimbursement

• Work from home environment