DME Operations Lead: Compliance

3 weeks ago


Walnut Creek, United States National Association of Latino Healthcare Executives Full time

A healthcare leadership organization is seeking an Operational Specialist IV to oversee quality assurance for medical equipment referrals and manage compliance with medical necessity denials. The role involves developing training, leading project execution, and contributing to strategic business planning. Ideal candidates will have strong project management skills and regulatory knowledge. This position is based in Walnut Creek, California.
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    Job Summary: Operational Specialist IV is responsible for performing quality assurance reviews on Durable Medical Equipment (DME) referrals that have been denied based on patient benefits or medical necessity. This role also manages the processing of medical necessity denials, ensuring the inclusion of accurate and coverage-specific denial letter language...


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