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eclipse mobility
DME Case Manager
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Job Description
DME Case Manager A Durable Medical Equipment (DME) case manager is responsible for coordinating with medical providers, injured workers, and carriers through the management of the DME process. The goal of the case manager is to facilitate DME needed for medical purposes by patients for self-care in a home setting. Job Duties and Responsibilities
- Complete customer intake and verify eligibility with payers
- Requests for prior authorization of DME
- Review provider requests by telephone or through fax to ensure medical necessity for services that require pre-authorization
- Assist in ordering medical equipment needed for patient during recovery from surgery or for long-term use
- Apply nationally recognized criteria to determine medical necessity of services requested Education and Qualifications
- High school diploma or GED equivalent
- Possess good communication skills
- Attention to detail
- Must have previous DME/Utilization Review/Prior Authorization experience
- Understanding of ICD 10, HCPCS and billing modifiers
- Must be computer proficient: Microsoft Office, Word, and Excel, typing skills 30 WPM or above