Durable Medical Equipment (DME) Operations Specialist

Our Mission: Quality compassionate care for all.

Our Vision: Reimagine health care through connection service and innovation.

Our Core Values: Be Kind Trust and Be Trusted Work Together Strive for Excellence.

Qualifications:

• Minimum of one (1) of the following required:
  • Minimum of two (2) years DME experience.
  • Minimum of two (2) years healthcare billing experience.
• Knowledge of rules and regulations pertaining to Medicare Medicaid and other contracted services required.
• Possess knowledge and understanding with rules and regulations regarding coverage of durable medical equipment and respiratory claims for Medicare/Medicaid and other Third party payers preferred.
• Excellent organizational skills detail-oriented a self-starter possess critical thinking skills and be able to set priorities and function as part of a team as well as independently.
• Commitment to working in a team environment and maintaining confidentiality as needed.
• Excellent verbal and written communication skills including the ability to communicate effectively with various audiences.
• Excellent interpersonal skills with the ability to manage sensitive and confidential situations with tact professionalism and diplomacy.
• Possess and maintain computer skills to include working knowledge of Microsoft Office Suite and ability to learn other software as needed.

Job Specific Duties:

• Audits patient account documentation and provider related clinical documentation for insurance billing per department protocol.
• Assists billing office with appeals re-determinations and other billing issues related to patient accounts.
• Monitors reimbursements and allowables related to insurance claims to maximize reimbursement.
• Monitors Medicare coverage criteria and billing regulations to ensure LHME is compliant with Local Coverage Determinations (LCD) per department protocol.
• Acts as a resource for documentation requirements for appropriate stakeholders.
• Performs a variety of administrative accounting and billing tasks in order to complete the business cycle.
• Provides excellent customer service.
• Timely and accurately responds to all audit requests per department procedures.
• In collaboration with assigned leadership reviews and provides feedback and updates to policies and procedures.
• In collaboration with assigned leadership establishes controls for an effective DME compliance program and monitors DME compliance training for staff.
• Responds to reported and/or detected DME compliance concerns and advises assigned leadership per department protocol.
• Develops and monitors LHMEs DME compliance program in collaboration with assigned leadership to ensure that LHME is meeting HQAA standards of care.
• Stays abreast of DME and Respiratory services and changes.

The above essential functions are representative of major duties of positions in this job classification. Specific duties and responsibilities may vary based upon departmental needs. Other duties may be assigned similar to the above consistent with knowledge skills and abilities required for the job. Not all of the duties may be assigned to a position.

Maintains regular and consistent attendance as scheduled by department leadership.

Shift:

Schedule:

Logan Health operates 24 hours per day seven days per week. Schedules are set to accommodate the requirements of the position and the needs of the organization and may be adjusted as needed.

Notice of Pre-Employment Screening Requirements

If you receive a job offer please note all offers are contingent upon passing a pre-employment screening which includes:

• Criminal background check

• Reference checks

• Drug Screening

• Health and Immunizations Screening

• Physical Demand Review/Screening

Equal Opportunity Employer

Logan Health is an Equal Opportunity Employer (EOE/AA/M-F/Vet/Disability). We encourage all qualified individuals to apply for employment. We do not discriminate against any applicant or employee based on protected veteran status race color gender sexual orientation religion national origin age disability or any other basis protected by applicable law. If you require accommodation to complete the application testing or interview process please notify Human Resources.