Durable Medical Equipment Insurance Specialist

2 days ago

Cleveland, Ohio, United States Medical Service Company Full time
Job Title: DME Insurance Verification Specialist, Tier 2

Medical Service Company is a family-owned and operated durable medical equipment and respiratory provider with over 70 years of experience. We are proud to be a 13-Time recipient of the prestigious NorthCoast 99 Award as a Top Workplace to work and a two-time recipient of the National HME Excellence Award for Best Home Medical Equipment company in the US.

We are seeking a highly skilled and detail-oriented DME Insurance Verification Specialist, Tier 2 to join our team. As a key member of our revenue cycle team, you will be responsible for monitoring and improving processes related to the quality, appropriateness, and timeliness of reimbursement information requirements for our order processing activities.

Responsibilities:
  • Initiate renewal authorization requests with insurance companies and government payers.
  • Monitor outstanding renewal authorization requests and initiate follow-up in a timely manner.
  • Work all outstanding held revenue related to prior authorizations for assigned insurances.
  • Handle claim denials due to missing prior authorization for assigned insurances.
  • Maintain accurate and complete records concerning billing activity.
  • Manage phone calls related to prior authorizations.
  • Train on PAR processes.
  • Process insurance changes when prior authorizations are needed.
  • Communicate obstacles or challenges to PAR Supervisor/Manager that may lead to inaccurate or untimely resubmissions of claims.
  • Serve as backup for prior authorization team Tier 1.
Qualifications:
  • Graduate of an accredited high school or GED equivalence.
  • Minimum 3 years of revenue cycle experience in healthcare.
  • Ability to multi-task in a fast-paced environment.
  • Detail and team-oriented.
  • Effective communication (verbal and written) and organizational skills.
  • Proven computer proficiency, use of multiple applications simultaneously.
  • Previous experience in prior authorizations and insurance verification required.
  • Knowledge of the HME/DME industry preferred.

Position starts at no less than $17/hour.

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