What are the responsibilities and job description for the DME Precertification Specialist II position at OrthoLoneStar PLLC?
About the Role :
We are seeking a highly motivated and detail-oriented DME Precertification Specialist II to join our team at Advanced Orthopaedics, A division of OrthoLoneStar. As a DME Precertification Specialist II, you will be responsible for ensuring that all necessary precertification requirements are met for our clients. This includes review medical records, verifying insurance coverage, and obtaining necessary authorizations. Your attention to detail and ability to work efficiently in a fast-[aced environment will be critical to success in this role :
Responsibilities :
- Verify insurance coverage for DME and obtain any necessary authorizations
- Review medical records and ensure that all necessary medical necessity requirements have been met in accordance with insurance medical policies
- Communicate and coordinate with vendors, patients and internal staff to provide DME
- Maintain accurate records of preauthorization activities
- Collaborate with other team members to support any other ancillary programs
Minimum Qualifications : .
Preferred Qualifications :
Skills :
The required skills for this position include strong analytical abilities to assess medical documentation and determine the appropriateness of DME requests. Excellent communication skills are essential for effectively liaising with healthcare providers and insurance representatives. Attention to detail is critical in maintaining accurate records and ensuring compliance with insurance requirements. Preferred skills, such as familiarity with DME products and insurance policies, enhance the specialist's ability to navigate complex situations and provide informed guidance to patients. Overall, these skills contribute to a streamlined precertification process, ultimately benefiting both the organization and the patients we serve.
