Essential Duties:
Under the general supervision of the Medical Necessity Supervisor, a Medical Necessity Specialist is responsible for maintaining a positive, helpful attitude and approach in providing excellent customer service to all customers which include; patients, clients, referral sources, physicians, and sales representatives in verifying benefits and coverage with the health plan, sending out and obtaining medical necessity documentations in a timely manner.
Responsibilities:
- Responsible for creating, sending out and/or obtaining all medical necessity documentations in a timely manner and log information in the system.
- Maintains and updates all medical necessity information in the system such as patient information, payer changes, and other information to support billing process.
- Communicates with physicians offices, medical groups, MSO, and health plans on a daily basis for medical necessity documentation and for the continuation of patient equipment.
- Communicates to Lead or Supervisor or Manager regarding progress, updates, problems, error trends, new findings, inaccurate or untimely claim submission, and others in a timely manner.
- Maintains a daily follow-up system and checks the starting & expiring dates of medical necessity documentations.
- Submits appropriate documentation such as prescription, labs results, medical justification, authorization, eligibility, and others as necessary and applicable in a timely manner.
- Works on Hold Revenue report, group projects, goals and renewal process.
- Maintains accurate and complete daily productivity report.
- Performs other duties as assigned.
- Remains knowledgeable on product and insurance coverage issues in order to inform
- patients of copays and other benefit information
- Attends all departmental meetings, company meetings, and in-services
- Reports to work daily and is ready to work at the scheduled start time
- Works Saturday assignment as needed or scheduled
- Performs any other duties that may be requested by supervisor or management
- Understand and adheres to all of SuperCare Health company policies
- To remain knowledgeable to date on all products, guidelines and insurance coverage trends
- Maintain a professional safe and clean work environment.
- Understand and adheres to all of SuperCare Health company policies.
- Perform all other duties as assigned and required
- Must meet minimum of monthly goals
Education and or Work Experience:
- Experience with Medical Supply Company
- Knowledge of diagnosis and Medical terminology
- Excellent Customer Service skills
- Detail oriented
- Proficiency in Microsoft Word, Excell, Outlook, and PowerPoint
- Experience in healthcare, medical and/or HME industry (preferred)
- Be able to work on multiple tasks. Plan and prioritize actives to achieve results and meet deadlines
- Strong organizational skills and detail oriented
Perks:
- Paid Training
- Sick Time
- Paid Mileage
- Growth Opportunities
- Employee Referral Reward Program
- Employee Discount Program
Any employment proposal is contingent upon satisfactory completion of: Background Check, Reference Check(s), Driving Record (if applicable), Pre-employment Drug and TB Tests __
What Rick's Medical Supply is About
"We treat our customers like family. Rick's Medical Supply, Inc. has been the source for medical supplies and equipment in the Roseburg, OR area for over forty years because of our superior commitment to provide you with the absolute best in product quality and customer service. Our highly trained staff will help you make the best choices for your needs, while providing you with friendly service and expert advice. Every effort is made to ensure that your experience is as pleasant and efficient as possible. Stop by and see us! Our business is your good health."
Connect With Us!
Company Website https://ricksmedical.com/
Company Business Hours - 8:30 AM – 5:30 PM PST
LinkedIn https://www.linkedin.com/company/rick-s-medical-supply/
Facebook https://www.facebook.com/ricksmedicalsupply
Araceli Richardson - Jr. Recruiter LinkedIn