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 Supplier, and office support personnel to execute operational procedures in alignment with company policies and established timelines.

• Carefully assess orders for precision and educate Funding Specialists when discrepancies are found.

• Maintain an up-to-date understanding of durable medical equipment, company policies and procedures, as well as insurance eligibility and reimbursement regulations.

• Ensure adherence to company policies and procedures.

• Oversee the transaction cycle time from Completion of Coding and Pricing to Completion of Documentation.

• Provide support to Funding Specialists during periods of PTO, leave, open positions, and other identified needs.

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

• Request, compile, evaluate, and verify funding package documentation, prescriptions, Letters of Medical Necessity, evaluations, price lists, and forms.

• Review documentation for compliance with payer guidelines and educate relevant parties when documentation is found to be incomplete or inaccurate.

• Collect and confirm insurance coverage details and communicate benefits and coverage to clients.

• Maintain communication with clients regarding their financial responsibilities and guide them through hardship processes where permissible.

• Adhere to document-collection escalation policies and coordinate tasks related to Funding Action Required.

• Research payer documentation requirements and update the UPD accordingly.

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

• Complete additional funding tasks encompassing Coding and Pricing, Submissions, Authorization collection, PPQA, and Delivery Verifications.

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

• Document best practices, identify training opportunities, and coordinate improvements or updates to the UPD.

• Promote problem-solving and collaboration within the team.

• Inspire and acknowledge team members for their contributions.

• Assist with customer complaints, billing and payer issues, and correspondence.

• Support performance monitoring and evaluation initiatives.

• Communicate team status, task achievements, and direction to management.

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

• Assist with new business acquisitions and temporary branch processing requirements.

• Undertake other related tasks and special assignments as requested.

⛳️ Requirements

• A minimum of 3 years of experience related to Durable Medical Equipment and/or Complex Rehab Technology is required.

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

• Extensive knowledge of processes and insurance guidelines necessary to secure funding for Durable Medical Equipment and/or Complex Rehab Technology.

• Comprehensive understanding of insurance verification for DME.

• Experience with applications such as Mobility Advisor or data management systems is required.

• Proven track record of exceptional people skills, including effective communication and interpersonal abilities.

• Strong leadership capabilities.

• Excellent team player.

• Strong organizational skills and keen attention to detail.

• Customer service oriented.

• Proficient in computer and technology skills.

• Good knowledge of Microsoft Office applications, including Outlook and PowerPoint.

• Experience with Excel, including spreadsheets and formulas, as well as Outlook email is required.

• Ability to serve as a strong role model for high performance and productivity.

• Capability to manage and develop team members remotely.

• Proficient in reading, analyzing, and interpreting general business reports, technical procedures, work instructions, and governmental regulations.

• Ability to write reports, business correspondence, and develop training materials.

• Competence in effectively presenting information and addressing inquiries from a diverse range of staff members.

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

🏝️ Benefits

• 401k

• Company paid Long Term Disability

• Tuition reimbursement

• Work from home environment