Full Time 40 hours Grade 009 Pharmacy SMH Location: 155 Bellwood Drive or 1815 S. Clinton Avenue

GENERAL JOB DESCRIPTION:

Under the supervision of the department manager, the DME Coordinator is responsible for insurance verification, assembly of needed documentation for billing, prior authorizations, reimbursement qualifications and patient and provider interactions. Works in conjunction with the billing department to assist with resolving denials and providing additional clinical documentation when necessary. Expected to work independently to insure patient needs are met as requested by the provider.

DUTIES AND RESPONSIBILITIES INCLUDED BUT NOT LIMITED TO:

PATIENT INTAKE:

• Evaluate home medical equipment referrals to verify insurance coverage.
• Obtain benefit information from third party payers to advise patients on their expected out of pocket costs related to deductibles, coinsurance, copayments or total charges if services are not covered.
• Acts as liaison between home care coordinators, discharge coordinators, and providers to obtain accurate information required for home medical equipment billing.
• Assessment and identification of specific needs for payer coverage of services to include proper documentation, and prior authorization.
• Maintain referral, census logs and reporting as necessary.
• Assist patients onsite with home medical equipment consultations and selection.
• Coordinates equipment deliveries with patient, facility and providers.
• Confirm delivery tickets for provided services after review for accuracy.
• Coordinate required information for denied claims for billing
  • Participate in payer audits and collect, summarize and send requested information
    

QUALIFICATIONS:
High school diploma and 4 years of related hospital credit services experience or Bachelor's degree in Business Administration, Health Care Administration, Psychology, or related discipline and 1 year of related experience; or equivalent combination of education and experience. Medical terminology required.

All applicants must apply online.

EOE Minorities/Females/Protected Veterans/Disabled