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Durable Medical Equipment Specialist

2 months ago

Fernandina Beach, Florida, United States Jax Spine & Pain Centers Full time

Jax Spine & Pain Centers is seeking a dedicated and detail-oriented Durable Medical Equipment (DME) Specialist/Medical Assistant to join our growing team. In this role, you will play a vital part in ensuring patients receive the necessary medical equipment they need for their recovery and well-being.

As a DME Specialist, your primary responsibility will be processing and verifying patient DME authorizations. You will collaborate with insurance companies to confirm benefits, obtain pre-certifications, and ensure timely approvals for DME requests. Your expertise in medical terminology, CPT, and ICD-9 codes will be essential in accurately documenting patient information and navigating the complexities of insurance procedures.

This position requires strong communication and organizational skills. You will interact with patients, healthcare providers, and insurance representatives to facilitate a smooth and efficient referral process. Your commitment to providing exceptional customer service and maintaining patient confidentiality is paramount.

Essential Functions:
  • Obtain and review DME authorization requests, adhering to established protocols and utilizing computer programs to validate insurance eligibility and requirements.
  • Contact insurance companies to verify benefits, obtain pre-certifications, and authorizations as required.
  • Accurately enter authorization and pre-certification information into the system and attach supporting documentation.
  • Ensure timely feedback and follow-up on all authorization and pre-certification requests.
  • Process referrals for authorization within regulatory or company-defined timeframes.
  • Communicate effectively with other providers' offices, insurance companies, and patients regarding referral status and updates.
  • Maintain accurate patient records and documentation in electronic medical charts.
  • Demonstrate proficiency in Microsoft Office products and other relevant software applications.
Qualifications:
  • High school diploma or equivalent required.
  • Previous experience as a referral coordinator or background in general office work is preferred.
  • Ability to comprehend and follow established office routines and policies.
  • Understanding of insurance carriers' plans and guidelines.
  • Demonstrated working knowledge of medical terminology, CPT, and ICD-9 codes.
  • Strong oral and written communication skills.
  • Ability to multi-task efficiently and effectively.
  • Good interpersonal and organizational skills.
  • Highly detail-oriented.