SUMMARY:

The Order Review Specialist is responsible for analyzing all aspects of orders to ensure required documentation and authorizations have been obtained and required guidelines have been met for goods and services provided by the company. This includes meeting all requirements for applicable insurances, state, federal, and accreditation agencies along with DASCO policy and procedures, which will ensure compliant billing and payment collection.

ESSENTIAL FUNCTIONS:

Complete and accurate review of all records of delivered goods and services, including required documentation such as delivery tickets, prescriptions, medical studies, medical records, and authorizations.
Review and log authorizations accurately to ensure payment and reduce denial rate.
Process Change of Insurance tasks timely and accurately to secure proper authorization for payment.
Identify insurance medical documentation requirements, prior authorization updates, price file updates, and escalate identified issues to manager.
Work cooperatively with other departments to secure payments and reduce denials, including referral intake, branches, accounts receivable, and others as needed.
Maintain compliance with all applicable rules and regulations.
Support department projects and initiatives to achieve production goals.
Other duties as assigned by the Manager.

REQUIRED EDUCATION AND/OR EXPERIENCE:

High School diploma or GED equivalent.

PREFERRED EDUCATION AND/OR EXPERIENCE:

Six months’ accounts receivable or documentation/prior authorization experience in a healthcare/insurance/medical environment.

ADDITIONAL QUALIFICATIONS:

Competence in Windows-based applications.

COMPETENCIES:

Detail oriented

Teamwork

Multi-tasking

Problem solving

Adaptability

POSITION TYPE/EXPECTED HOURS OF WORK:

This is a full-time position, and hours of work and days are Monday through Friday, 8:00 a.m. to 5:00 p.m. to start, with the possibility of flex scheduling based on department needs and individual performance.

SUPERVISORY RESPONSIBILITY:

This position has no supervisory responsibilities.

WORK ENVIRONMENT:

This position is a fully remote position that requires routinely using standard office equipment such as computers, multiple screens, and phones.

PHYSICAL DEMANDS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

This is primarily a sedentary position, spending most of the workday sitting at a desk in an office setting. Specific vision abilities required by this job include both close and distance vision, color and peripheral vision, depth perception and ability to adjust focus.

TRAVEL:

No travel is typically not expected for this position.

OTHER DUTIES:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

EEO STATEMENT:

DASCO provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, DASCO complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

DASCO expressly prohibits any form of workplace harassment based on race, color,

religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of DASCO’s employees to perform their job duties may result in discipline up to and including discharge.

Dasco HME jobs

Order Review Specialist