Job Posting Title: Central Validation Specialist
Department: Central
Employment Status: Full Time
Location: 1877 NE 7th ave
Portland, OR 97212
Care Medical & Rehabilitation Equipment, Inc. is the largest privately-owned durable medical and rehab equipment provider in the Northwest with 9 operating branch locations throughout Oregon and Washington.
General Position Summary: This position is responsible various forms of communication with outside medical professionals, referral sources, payers and clients. These communications include initial, renewed and revised equipment orders from the prescribing authority. Review all medical necessity documentation to ensure that claims submitted to any payer source are compliant.
Job Responsibilities:
Complete, send and follow up until confirmations of Verbal Order (VCO) are received
Send and follow up until Certificates of Medical Necessity are received, request corrections or additions to any orders of CMNs that have errors or omissions.
Enter documents into the computer system as required for claims processing
Correct claim errors presented on the validation report relating to setup, CMN and authorizations
Change procedure codes in insurance claims as authorized for DSHS
Place order with the branch respiratory therapist to retest a patient when needed and when allowed by the payor.
Enter all initial prior authorizations into the computer system
Request and follow up until renewal/extended payor authorizations
Maintain valid prescriptions for repairs for Washington State Medicaid patients
Job Qualifications:
Education: High School Graduate or equivalent
Experience:
Required:
Preferred: Experience in the DME industry
Previous medical billing experience
Knowledge/Skills/Abilities: A candidate will need to possess excellent written and verbal communication skills, have knowledge of medical terminology, research skills, high level of attention to detail, strong problem solving skills, ability to organize, prioritize, meet deadlines and departmental standards, perform detail orientated tasks, possess initiative in researching and resolving claims issues and proficiency in Microsoft Office applications such as Word, Excel and Outlook.
Applicants must pass a background check and drug screen.
Benefits include paid time off, paid holidays including birthday holiday, group insurance, life insurance, voluntary STD and LTD, Flexible Spending Accounts, Supplemental Life and 401(k). Discounts on automotive repairs and discounts on products Care Medical sells.
Care Medical & Rehabilitation Equipment, Inc is an Equal Opportunity Employer.
If you wish to be considered for this position and meet the qualifications, please submit a cover letter with your salary requirements and resume to: ambera@caremedical.com. In the subject line of your email you must include what position you are applying for and for what City and State.