Hybrid Administrative Clerk - Medical Setting - TEKsystems

Durable Medical Equipment Clerk

Downey, CA - Two month onsite training, hybrid schedule to follow

$23.00 - $28.00 HR

Shift: 9:30am-6pm

3 month contract with potential to extend

Description:

Under the supervision of the DME Manager, the Durable Medical Equipment (DME) Clerks responsibilities include receiving, reviewing and authorizing the referrals for DME and Prosthetic & Orthotic (P&O) orders. Data input for electronic ordering of DME and P&O items from outside vendors. Analyze and process DME forms and medical record review to ascertain appropriateness of ordered DME or P&O items. Investigates and tracks pertinent patient information. Performs related departmental duties according to established DME policies and procedures. DME Clerk must have demonstrated a history of excellent service skills exhibited by

courtesy, cooperative spirit and tact when interacting with patients, families, and staff.

Essential Responsibilities:

-Receives high volumes of inbound calls.

-Receives, reviews and processes referrals for DME and P&O orders.

-Review and complete the Notice of Non-Coverage (NONC) Process

-Interprets Benefits for each patient as it applies to DME criteria

-Maintains an understanding of Regulatory Requirements

-Investigates and track pertinent patient information.

- Authorize and orders equipment from outside vendors, analyzing and processing DME forms and reviews medical review to ascertain appropriateness of ordered equipment or prosthesis.

-Understands the DME Referral (Orders or Prescriptions) and the administration of the Benefit according to the guidelines appropriate to the DME formulary or

Evidence of Coverage (EOC).

-Maintains a working knowledge of all benefit administration and formularies tools.

-Maintains a daily coordination of Claims/Invoice Management.

-Performs consistent professional Customer Service regarding DME information and services to members, providers, ancillary support, vendors, etc.

Preferred skillsets:

Knowledge of Regulatory Regulations (CMS, Medi-Cal, TJC, NCQA, DMHC); Medical Terminology.

Education

High School Diploma

About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.