Compression Care ยท 2 days ago
DME Benefit Verification Specialist
United States
Full-time
Remote
Entry Level
$45K/yr - $48K/yr
1+ years expCompression Care, LLC is a leading national provider of Durable Medical Equipment (DME), committed to delivering high-quality products and exceptional service to our patients. The Benefit Verification Specialist will be responsible for verifying patient insurance benefits related to DME, ensuring accurate documentation, and facilitating the authorization process to guarantee timely patient access to necessary equipment.
Health CareMedical DeviceSoftware
Hiring Manager
Joshua Perkins
Responsibilities
Insurance Verification: Review patient insurance information to determine coverage for Compression Garments
Benefit Analysis: Verify patient-specific benefits, including coverage details, cost-sharing responsibilities, and provider access options, adhering to program-specific standard operating procedures (SOPs)
Authorization Coordination: Initiate and manage prior authorization requests, including documentation and follow-up with insurance payers
Documentation: Accurately document all verification and authorization activities in the electronic medical record (EMR) system. Azalea and a proprietary system are the two we use most often. Send pre-filled prescription requests to physicians
Communication: Collaborate with referral sources, healthcare providers, and internal departments to gather required information for benefit verification and respond with benefit information to patients and referral sources
Compliance: Ensure all activities comply with HIPAA regulations and company policies
Reporting: Identify and report coverage trends or delays to management
Continuous Improvement: Participate in training sessions and stay updated on changes in insurance policies and procedures
Qualification
Required
Minimum of 1 year in durable medical equipment insurance verification, with knowledge of DME products, billing, coding, and terminology
High school diploma or equivalent required; associate degree or higher in a related field preferred
Proficiency in EMR systems and Microsoft Office Suite
Familiarity with insurance verification tools such as Availity, CGS, and an understanding of various payer requirements
Strong knowledge of insurance processes, including Medicare, Medicaid, and commercial payers
Strong verbal and written communication skills
Excellent organizational skills with attention to detail
Ability to work in a fast-paced environment and adapt to changing procedures and regulations
Preferred
Certified Medical Reimbursement Specialist (CMRS) or Certified Medical Insurance Specialist (CMIS) credentials
Prior experience with Lymphedema and the LTA
Knowledge of HIPAA regulations and patient confidentiality standards
Benefits
Health, dental, and vision insurance
401(k) with company match
Paid time off and holidays
Opportunities for professional development and career advancement
Company
Compression Care
Compression Care is a medical service that provides compression garments, custom fittings, and lymphedema support services.
2-10 employees
Funding
Current Stage
Early StageCompany data provided by crunchbase