JOB DESCRIPTION:

DME COORDINATOR

SUMMARY:

The DME coordinator is responsible for the pre-service evaluation of authorization requirements for Durable Medical Equipment that has been prescribed by the Practitioner. Performs record reviews of clinical information to confirm proper documentation for all DME items that are ordered and fitted. Works closely with clinical staff and management to ensure the appropriate items are being completed and billed within a timely manner.

ESSENTIAL FUNCTIONS:

1. Corresponds and communicates with staff, providers and members in regard to DME orders, fittings, insurance verifications, authorizations, and cost estimates.
2. Possesses strong interpersonal/verbal/written communication skills.
3. Ability to effectively present information and respond to questions and concerns from peers and management.
4. Detail oriented, organized and the ability to multi-task.
5. Properly notates all areas visible to staff of where a DME order stands and whether they are ready for fitting and what they’re potential cost is, and collection of cost.
6. Responsible for timely order processing and obtaining authorizations.
7. Maintains a high level of professional and technical knowledge of relevant payor rules.
8. Ensures accurate completion of appropriate forms and prescriptions within the Breg Vision platform; following all necessary compliance and regulatory requirements.
9. Responsible for inventory management, including organizing and tracking inventory in all locations, performing audits, and managing defective product returns and exchanges.
10. Responsible for proper measuring, application, and education on the appropriate use/care of DME and providing accurate information to patients.
11. Educates clinic staff on how to appropriately handle, document and fit all DME items in our inventory.
12. Builds and maintains relationships with clinic staff on varying levels.
13. Responds to customer questions and/or issues of moderate to complex scope and elevates necessary complaints to Supervisor
14. Schedules fitting appointments appropriately
15. Maintains access to automated portals and web-based authorization tools.
16. Works closely with billing in regard to DME denials.
17. Treats Protected Health Information (PHI) with the strictest confidentiality in accordance with HIPAA standards and FSA’s policies and procedures.
18. Performs other duties as assigned.

EXPERIENCE:

• Required – High School Diploma or GED
• Required - 2+ years of experience in a managed care setting, medical office or facility setting with medical administration duties.
• Required - Microsoft Word, Excel and Outlook knowledge.

Medical Office experience in Spine/Ortho Care

Ideal candidate would have DME Brace fitting experience

Athletic trainer or PT Aide/Assistant