DME Clerk

1 week ago

Pasadena, California, United States Randstad USA Full time
Job Opportunity: DME Clerk

Randstad USA is seeking an experienced DME Clerk to join their team in Pasadena, CA. This role involves working with a leading healthcare company, providing excellent customer service, and gaining valuable experience.

Key Responsibilities:
  • Receiving, reviewing, and authorizing referrals for DME and P&O orders.
  • Processing referrals for DME and P&O orders, including reviewing and completing the Notice of Non-Coverage (NONC) process.
  • Interpreting benefits for each patient as it applies to DME criteria.
  • Maintaining an understanding of regulatory requirements.
  • Investigating and tracking pertinent patient information.
  • Authorizing and ordering equipment from outside vendors, analyzing and processing DME forms, and reviewing medical reviews to ascertain appropriateness of ordered equipment or prosthesis.
  • Answering phones, processing orders, and verifying benefit eligibility (approximately 90 calls per day).
Requirements:
  • Previous 1 year clerical experience in an acute care/healthcare setting.
  • DME or Home Health experience, with knowledge of DME guidelines, care management, and regulatory requirements.
  • Knowledge of regulatory regulations (CMS, Medi-Cal, TJC, NCQA, DMHC) and medical terminology.

This is a 3-month contract position with the possibility of extension and potential conversion to a permanent role. If you have excellent customer service skills and experience in a healthcare setting, we encourage you to apply for this exciting opportunity.

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