Durable Medical Equipment Procurement Specialist

The Durable Medical Equipment Procurement Specialist is responsible for ordering Durable Medical Equipment supplies for members via network providers. The successful candidate will be responsible for validating prescriptions, submitting referrals to vendors and following up on incomplete requests.

ESSENTIAL RESPONSIBILITIES:

• Verify eligibility and/or benefit coverage for requested services.
• Verify all necessary documentation has been submitted for pre-service request.
• Enter referrals in system using ICD 10 and CPT coding.
• Assist with faxing correspondence to PCP’s, Specialists, related to requests as needed.
• Follow all regulatory policies and procedures, privacy and security standards in accordance with government agencies including HIPAA requirements.
• Time management skills and the ability to work independently to meet goals and sensitive timelines
• Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution
• Ability to be trustworthy, dependable, and team-oriented for fellow employees and the organization
• Monitor work queue activities relating to UM requests and authorizations.
• Other duties as assigned

Qualities in a candidate:

• Strong clerical and organizational skills, with attention to detail
• Strong written and oral communication skills
• Strong Customer Service
• HIPAA knowledgeable
• Ability to work independently with minimal supervision.
• Familiarity with medical prescriptions
• Experience as a pharmacy tech preferred

JOB SPECIFICATIONS:

• High school degree or equivalent.
• Previous (3-5 years) administrative or related experience required, preferably in medical or insurance industry
• Ability to interact with all levels of internal and external personnel.
• Strong written and verbal communication skills.
• Expert knowledge of standard corporate software packages.
• Bilingual encouraged to apply.
• Proof of COVID vaccination

EEO Statement

Element Care is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, sex, color, religion, national origin, sexual orientation, protected veteran status, or on the basis of disability.

Element Care is committed to valuing diversity and contributing to an inclusive working environment.