Medical Device Coordinator

Job Description

The Medical Device Coordinator will be responsible for reviewing and processing new referrals from patient intake to shipping and insurance approval. This role is the primary contact for patients, clinics, and Clinical Area Managers within their designated territory. Responsibilities include patient intake and contact throughout the referral process, obtaining payer required documentation, submitting, and obtaining insurance authorizations, obtaining patient documents, and assisting with patient payment programs.

This is a full-time onsite position based in Fairhope, AL. The ideal candidate will have extensive customer service experience, preferably in a call center environment, as well as substantial experience working directly with providers in healthcare or DME settings.

Responsibilities:

• Follow Electromed mission and core values, while striving to achieve company goals
• Understand and adhere to local State and Federal healthcare regulatory and compliance rules
• Maintain patient flow and relationships with physicians and their staff, discussing treatment options, providing nurse and patient education, and acting as the main point of contact between physician, patient, and Clinical Area Manager (CAM)
• Review new patient referrals and intake information for required documentation and medical necessity, insurance, demographics, clinical history, etc.
• Collect and organize medical records, maintain electronic charts including comprehensive care plans, medical information, treatment records, and billing data
• Evaluate patients for proper authorizations for treatment coverage, perform benefit verification, and submission of authorization requests
• Develop a payer knowledge base related to diagnosis, coverage guidelines, and medical criteria
• Communicate professionally and effectively; requires extreme attention to detail, problem resolution, and knowledge of medical terminology, Protected Patient Info, and HIPAA laws
• Develop relationships with patients and providers by maintaining exceptional service and follow-up care
• Educate patients on the therapeutic benefits of airway clearance devices to promote prescribed adherence
• Discuss therapy and treatment costs, collect, and update necessary patient information and forms for insurance processing
• Assist internal and field teams, payers, and patients in understanding payer methodologies and resolution of order-related issues through outreach and response to inquiries
• Effectively submit insurance requests to obtain authorization, utilizing tools such as web portals and authorization partners

Requirements

To succeed in this role, you must have:

• A high school diploma or GED required; degree preferred
• Extensive customer service experience with phone contact, preferably in a call center environment
• Substantial experience working directly with providers in healthcare or DME settings
• Strong and solid experience working with insurance companies in the capacity of benefits & coverage, and authorizations
• Previous experience in medical device or other healthcare environments required
• Proficiency working with Microsoft Office suite
• Knowledge of medical terminology
• Familiarity of medical documentation
• Knowledge of Protected Patient Info and HIPAA laws
• Proven success working directly with sales teams preferred
• Experience with DME billing preferred
• Experience with Medicare part B coverage
• Experience with national payers
• Knowledgeable of insurance requirements with the ability to determine medical justification to ensure proper reimbursement
• Strong knowledge of medical insurance benefits and authorization processes
• Must live in or in close proximity to Fairhope, AL
• Available to work onsite full-time