CONTRACT ROLE

REMOTE

Key Responsibilities:

• Review and evaluate financial documentation and insurance policies for DME coverage.
• Coordinate with patients to gather required financial and insurance information.
• Verify eligibility and benefits with insurance providers for DME requests.
• Ensure compliance with payer-specific guidelines and documentation requirements.
• Collaborate with healthcare providers to obtain prescriptions, medical necessity letters, and supporting documentation for DME claims.
• Submit and monitor prior authorization requests for DME approvals.
• Resolve claim issues or denials by coordinating with insurance companies and patients.
• Maintain accurate records of financial assessments, approvals, and correspondence in the system.
• Communicate approval statuses or required actions to patients and providers in a timely manner.
• Stay updated on changes in insurance policies, DME billing codes, and regulatory requirements.