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Kestra Medical Technologies, Inc. · 5 days ago

Customer Order Specialist - Monday - Friday, 1st Shift (CST)

United States

Full-time

Remote

New Grad, Entry Level

Kestra Medical Technologies, Inc. is a company focused on innovative cardiac medical device solutions, combining modern wearable technologies with proven device therapies. They are seeking a Durable Medical Equipment Customer Order Specialist responsible for processing prescriptions and managing patient communications regarding medical equipment rentals and insurance authorizations.

Health CareHealth DiagnosticsMedical Device

Growth Opportunities

Responsibilities

Coordinate with sales representatives, physician's office, and applicable internal/external personnel in regard to medical records and information needed to obtain pre-authorization and benefits upon intake of new patient referrals. Confirm medical records meet medical necessity based on applicable insurance guidelines. Promptly follow-up on patient referrals, physician prescriptions and/or physician work orders

Verify eligibility and benefits of patient health insurance specific to Durable Medical Equipment (DME) by contacting insurance companies by phone, accessing insurance website portals, and utilizing Kestra’s medical billing software. Responsible for verification of active coverage, deductibles, accumulations, coinsurance, and pre-authorization requirements

Initiate, track, and complete pre-authorizations requests, including notifying applicable parties of the determination. Assist with appeals for Prior Authorization denials

Upon authorization, place orders for Durable Medical Equipment, notify, and dispatch patient product fitters

Review information and/or reports to confirm scheduled fitters arrive at destination in a timely manner

Review 'Delivery Tickets' to confirm they were completed accurately and signed

Perform data entry into medical billing software and other software (Salesforce) including patient demographics, prescribing physician’s information, insurance payor information, HCPCS procedure codes, ICD-10 diagnosis codes, etc

Regularly contact and communicate with Team Members, insurance companies, vendors, sales representatives, doctor’s offices, practitioners, clearinghouses, billers, and other applicable companies and associates. Send updates on prior authorizations, claims, patient benefits, orders, and other information as appropriate

Regularly communicate with patients to discuss their insurance benefits, out-of-pocket costs, and product payment arrangements

Escalate issues within insurance carriers when not able to obtain reasonable information

Answer incoming phone calls to office and route messages accordingly

Routinely export/import data from one software to another software

Create forms through auto-populating data into custom fields

Perform detailed notetaking with high accuracy on pertinent information

Utilize Adobe Acrobat Pro to create and edit PDF files: insert/move/delete pages; edit/add/redact text; save meta data, create templates, export/import data through plugin, etc

Consistently follow up with patients to confirm patient satisfaction

Accurately complete forms/applications and send out to applicable destination

Exercise patience and empathy when communicating with patients and customers

Be aware of and adapt to changes in medical regulations and processes

Participate in on-call and off hours coverage. Hours on-call and worked may include evenings, weekends, and holidays

Adhere to ***Pledge of Confidentiality***

Qualification

Medical billing softwareDurable Medical Equipment (DME)Insurance verificationSalesforceAdobe Acrobat ProCommunication skillsTeamworkEmotional Intelligence

Required

Knowledgeable in Kestra DME offerings, its features and benefits, and process to uphold its standards for excellence

Comfortable working CST hours (M-F)

Confirm medical records meet medical necessity based on applicable insurance guidelines

Promptly follow-up on patient referrals, physician prescriptions and/or physician work orders

Responsible for verification of active coverage, deductibles, accumulations, coinsurance, and pre-authorization requirements

Initiate, track, and complete pre-authorizations requests, including notifying applicable parties of the determination

Assist with appeals for Prior Authorization denials

Upon authorization, place orders for Durable Medical Equipment, notify, and dispatch patient product fitters

Review information and/or reports to confirm scheduled fitters arrive at destination in a timely manner

Review 'Delivery Tickets' to confirm they were completed accurately and signed

Perform data entry into medical billing software and other software (Salesforce) including patient demographics, prescribing physician's information, insurance payor information, HCPCS procedure codes, ICD-10 diagnosis codes, etc

Regularly contact and communicate with Team Members, insurance companies, vendors, sales representatives, doctor's offices, practitioners, clearinghouses, billers, and other applicable companies and associates

Send updates on prior authorizations, claims, patient benefits, orders, and other information as appropriate