Funding Specialist Lead

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

📋 Description

• Collaborate with the Division Funding Director, Funding Manager, Funding Supervisor, Branch Manager, Rehabilitation Technology Supplier, and office support staff to ensure operational procedures are completed in accordance with company policy and timelines.

• Carefully review orders for accuracy and provide education to Funding Specialists when discrepancies are found.

• Cultivate and maintain 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 time from Coding and Pricing Complete to Documentation Complete.

• Assist Funding Specialists during PTO, leave, open positions, and other identified requirements.

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

• Adhere to documentation follow-up frequency and escalation policies.

• Request, collect, review, and validate funding package documentation, prescriptions, Letters of Medical Necessity, evaluations, price lists, and required forms.

• Confirm that documentation aligns with payer guidelines and educate relevant parties when documentation is incomplete or incorrect.

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

• Sustain client communication, including guidance on financial responsibility and hardship processes where applicable.

• Coordinate funding activities and complete associated tasks, including Coding and Pricing, Submissions, Authorization collection, PPQA, and Delivery Verifications.

• Investigate payer documentation requirements and resolve issues related to the funding process.

• Provide direction and support to staff.

• Document best practices, identify training and improvement opportunities, and address discrepancies or updates in UPD.

• Facilitate problem-solving and collaboration among team members.

• Inspire and motivate team members while recognizing their achievements.

• Address customer complaints, billing and payer concerns, and related correspondence.

• Assist in performance monitoring and evaluation efforts.

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

• Conduct routine audits to pinpoint coaching opportunities and maintain high levels of staff performance.

• Support new business acquisitions and branches with temporary processing requirements.

• Execute other related duties and special assignments as needed.

⛳️ Requirements

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

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

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

• In-depth understanding of insurance verification processes for DME.

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

• Exceptional interpersonal, communication, and people skills.

• Strong leadership capabilities.

• Proven ability to work effectively as part of a team.

• Excellent organizational skills and attention to detail.

• Driven by a commitment to customer service.

• Proficient in computer and technology skills.

• Familiarity with Microsoft Office applications, including Outlook and PowerPoint.

• Experience using Excel, including spreadsheets and formulas, and Outlook email is required.

• Capability to manage and develop team members remotely.

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

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

• Competence in effectively presenting information and responding to inquiries from various staff members.

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

🏝️ Benefits

• 401k

• Company-paid Long Term Disability

• Tuition reimbursement

• Work from home environment