Durable Medical Equipment Coordinator Coastal Care Services, Inc. - Doral, FL Job Summary Currently seeking a Durable Medical Equipment (DME) Coordinator for a great opportunity in the Miami FL area to review doctors orders and applicable documentation to ensure that it meets pre-established medical necessity/appropriateness criteria. The ideal candidate will possess 1-3 years of experience in durable medical equipment criteria and have 1-3 years of Medicaid and Medicare coverage experience. Responsibilities and Duties Responsibilities of the Durable Medical Equipment (DME) Coordinator * Receive client requests by phone or e-fax for new orders, exchange, cancellation or pick-up for durable medical equipment and/or supplies. * Data enters insurance, client information and medical equipment information into proprietary computer system for timely and accurate delivery * Perform pre-certification and/or authorization activities for all requested durable medical equipment included as contracted services that meet eligibility and benefits coverage. * When necessary, request additional applicable information, receives and review additional information * Make a certification determination and send written authorization number to the appropriate provider and to referring physician or sender. * Refer requests that do not meet pre-established medical necessity/appropriateness criteria to peer clinical review for determination. * Assist in resolving client equipment problems. * Develop and maintain working knowledge of current home care products and services offered by an all applicable insurance guidelines regarding eligibility for coverage and reimbursement. * Maintain detailed documentation to record client, physician and referral source communications. * Coordinate with other departments as appropriate. * Notify supervisor of issues requiring higher- level resolution. * Adhere to customer service and phone performance standards. * Comply with all applicable Policies and Procedures. Qualifications and Skills Requirements of the Durable Medical Equipment (DME) Coordinator * High School graduate with office experience * 1-3 years of experience in durable medical equipment criteria * 1-3 years of Medicaid and Medicare coverage experience * Medical Terminology/ICD-10/ HCPC knowledge * Effective verbal and written communication skills * Typing skills of 30 wpm. * Proficient in MS Windows and MS Office Suite * Ability to data enter, file, maintain records electronically Job Type: Full-time Experience: * DME Medicaid and Medicare coverage guidelines: 2 years * Durable Medical equipment order processing: 2 years Education: * High school or equivalent Language: * Spanish 13 hours ago - save job