<p>Summary:</p> <p>The Durable Medical Account Specialist will play a crucial role in customer intake and resupply. The ideal candidate will be reliable, self-motivated, have exceptional customer service and administrative skills, experience in the healthcare industry, and knowledge of Medicare, Medicaid, Private Insurance and Private Pay Billing. Attention to detail and team collaboration is required to ensure accurate and proper transfer of personal healthcare information, obtainment of insurance authorizations, order processing, and fulfillment.</p> <p>Responsibilities:</p> <ul> <li>Provides superior internal and external customer experience; prioritizing communication and maintaining professionalism </li><li>Receives and reviews durable medical equipment/home medical equipment (DME/HME) referrals and resupply requests to determine eligibility </li><li>Verifies benefits and obtains authorization for new and existing patients </li><li>Enters and manages personal healthcare information/medical documentation in ERM system </li><li>Collaborates with referral sources and providers to obtain certificate of medical necessity (CMN) documents, clinical documentation, and orders </li><li>Confirms all patient account information is accurate and complete in collaboration with billing to ensure reimbursement for supplies </li><li>Builds sales order templates; manages and processes new, existing, and refill orders </li><li>Provides customer/patient with product education as necessary </li><li>Monitors and advances work in progress (WIP) states. </li><li>Effectively communicates and collaborates with team members to drive results </li><li>Complies with laws and regulations and upholds all compliance and accreditation standards </li><li>Other duties as required/assigned. </li></ul> <p>Other information:</p> <p>Technical Expertise:</p> <ul> <li>Answering multi-line phone system </li><li>Knowledge of Electronic Medical Records (EMR) systems </li><li>Knowledge of DME/HME products, services, and applicable government regulations </li><li>Knowledge of HIPAA confidentiality requirements </li><li>Knowledge of medical claim billing and medical terminology </li><li>Knowledge of insurance policy and guidelines </li><li>Strong communication skills in speaking and writing </li><li>Organizational skills sufficient to maintain consistent accurate records </li><li>Efficient in computer skills and Microsoft Office proficient (Outlook/Word/Excel) </li><li>Compassion to serve and educate customers/patients </li></ul> <p>Education and Experience:</p> <ul> <li>High school or equivalent </li><li>Proficiency in Microsoft Office required </li><li>Minimum 2 years DME/Healthcare experience required </li><li>Brightree or Electronic Medical Records (EMR) experience a plus </li><li>EPIC experience a plus </li></ul> <p>Full Time</p> <p>FTE: 1.000000</p> <p>Status: Onsite</p>