DME Claims Specialist- Health First Medical Equipment Administration

Customer Service Intake Position

Customer Service intake position responsible for processing new DME orders from all referral sources. Associate will determine medical necessity and deliver appropriate and accurate information to all necessary departments to facilitate billing in compliance with regulatory and department processes. Associate will follow-up with referral sources and customers while delivering exceptional service.

Primary Responsibilities :

• Receive and process referrals from Hospitals, Provider offices, Rehab's, etc., and maintain frequent communication about delivery of setups.
• Review medical record for appropriate documentation of diagnosis, notes, and equipment ordered. Verify insurance benefits, copays and same / similar and review with customer all out of pocket expenses.
• Respond to customer inquiries or equipment orders by researching, understanding, and documenting the account. Create appropriate delivery documentation as necessary.
• Assist customers in a caring and knowledgeable manner, representing the organization as a skilled health care professional.
• Create billing documents needed per insurance guidelines as necessary and follow-up on those that are outstanding in a timely manner.
• Work reports such as held claims, open orders daily to ensure timely billing and follow-up on outstanding documentation.
• Coordinate delivery of equipment with DME Technicians and DME Supervisor.
• Contribute to a collaborative culture and positive work environment.
• Assist in over-the-counter sales and / or rentals, identifying needed equipment and / or supplies and instruct customers in the safe and proper use of equipment and supplies, including maintenance.
• Participate in store inventory as necessary. Ensure retail area is stocked with equipment when assigned to that workspace. Balance point of sale terminal cash drawers daily when assigned to retail workspace.

Work Experience

Minimum Qualifications :

Knowledge / Skills / Abilities :

Preferred Qualifications :

About Health First :

At Health First, diversity and inclusion are essential for our continued growth and evolution. Working together, we strive to build and nurture a culture that recognizes, encourages, and respects the diverse voices of our associates. We know through experience that different ideas, perspectives, and backgrounds create a stronger and more collaborative work environment that delivers better results. As an organization, it fuels our innovation and connects us closer to our associates, customers, and the communities we serve.

Schedule : Full-Time

Shift Times : 8 : 00am-4 : 30pm

Paygrade : 27