DME Coordinator (remote for FL state only)

• *DME Coordinator

• *Miami, FL (work at home position for FL state only)

Currently seeking a DME Coordinator for a great opportunity working remotely at a dynamic healthcare organization based in Miami, FL area. The ideal candidate will possess 3 years of experience receiving and coordinating new referrals for Durable Medical Equipment/Supplies. Able to work M-F 9-6pm or 4 weekdays plus Saturday; flexibility needed for rotating holidays and occasional weekend overtime.

• *MINIMUM QUALIFICATIONS/REQUIREMENTS:
• High School graduate with office experience.
• 1-3 years of experience in durable medical equipment criteria.
• 1-3 years of Medicaid and Medicare coverage experience.
• Orthotics and Prosthetics experience highly desired.
• Medical Terminology/ICD-10/ HCPC knowledge.
• Effective verbal and written communication skills.
• Typing skills of 30 wpm.
• Proficient in MS Windows and MS Office Suite
• Ability to data enter, file, and maintain records electronically.
• WAH (Work at Home) Requirements - Must have reliable high speed internet. Minimum standard speed for optimal performance of 10 x 1 (10mbs download x 1mbs upload) required. Must have a separate private workspace / desk area designated for home office to ensure absolute and continuous privacy while at work and have space for 2 monitors.
• *ESSENTIAL JOB FUNCTIONS/RESPONSIBILITIES:

Duties of the DME Coordinator include, but may not be limited to:

• Conducts screening and data entry of requests for authorization of Durable Medical Equipment.
• Coordinates the case managers review process and the staffing.
• Receives client requests by phone or e-fax for new orders, exchange, cancellation or pick-up for durable medical equipment and/or supplies.
• Data enters insurance, client information and medical equipment information into proprietary computer system for timely and accurate delivery
• Performs pre-certification and/or authorization activities for all requested durable medical equipment included as contracted services that meet eligibility and benefits coverage.
• Reviews doctor’s orders and applicable documentation to ensure that it meets pre-established medical necessity/appropriateness criteria.
• When necessary, requests additional applicable information, receives and review additional information
• Once the orders are verified to be complete and meeting appropriate criteria, it is processed accordingly the day it is received.
• Makes a certification determination and send written authorization number to the appropriate provider and to referring physician or sender.
• Refers requests that do not meet pre-established medical necessity/appropriateness criteria to peer clinical review for determination.
• Manage incoming calls from members and providers in regards services coordinated by Coastal.
• Assists in resolving client equipment problems.
• Develops and maintains working knowledge of current home care products and services offered by COASTAL an all applicable insurance guidelines regarding eligibility for coverage and reimbursement.
• Maintains detailed documentation to record client, physician and referral source communications.
• Coordinates with other COASTAL departments as appropriate.
• Notifies supervisor of issues requiring higher- level resolution.
• Adheres to COASTAL customer service and phone performance standards.
• Complies with all applicable COASTAL Policies and Procedures.
• Maintains a working knowledge of, and adheres to applicable federal/state regulations including but not limited to, laws related to patient confidentiality, release of information, and HIPAA.

The company is an Equal Opportunity Employer, in accordance with State and federal law. Coastal does not discriminate in employment opportunities or practices on the basis of race, color, religion, sex, national origin, age, disability, sexual orientation or any other characteristic protected by law. Opportunity is provided to all employees based on qualifications and job requirements.

• *We are a Drug-Free Work Place, we test for THC. This position is contingent upon completion and passing of a drug screening, verification of previous employment and a Level 2 Criminal Background check (please refer to the following website for more information and details on the Florida Care Provider Background Screening Clearinghouse: https://info.flclearinghouse.com.
• *No relocation/Local candidates only (FL state)'

Work Remotely

• Yes

Job Type: Full-time Pay: From $18.00 per hour

Benefits

• Dental insurance
• Health insurance
• Life insurance
• Paid time

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