DME Order Processing Representative - Part-time Remote

Position Overview:

Under the supervision of the Order Processing Manager, the Durable Medical Equipment (DME) Order Processing Representative role is responsible for managing the intake, verification, and processing of patient orders for medical devices such as bracing and CPAP equipment or other DME equipment, ensuring compliance with insurance requirements, and coordinating with healthcare providers and patients.

Key Responsibilities:

• Patient Intake & Documentation Review: Collect and review patient information, medical records, physician orders, and insurance details to confirm eligibility and medical necessity.
• Order Creation & Entry: Prepare and enter clean sales orders for DME products into the NikoHealth order processing platform, ensuring accuracy and adherence to company and regulatory guidelines. Accurately document all patient interactions in NikoHealth. Process and manage Orthofix Bone Growth Stimulator orders in the Stim Connect platform.
• Communication & Coordination: Liaise with patients, physicians, facilities, and insurance representatives to clarify orders, obtain prior authorizations, and resolve issues. Place Risen Medical introduction call to each new patient within 24 hours of receiving a new order.
• Process Improvement: Identify inefficiencies in order processing and recommend or implement improvements.
• Team Collaboration: Attend meetings, support sales representatives, and work with internal/external team members to ensure smooth order fulfillment
• Insurance Verification: Confirm active coverage, deductibles, coinsurance, and pre-authorization requirements by contacting insurers or using billing software
• Pre-Authorization Management: Initiate, track, and complete prior authorization requests, notifying all relevant parties of approval or denial

Required Skills & Qualifications

• Education: Minimum high school diploma or GED
• Technical Skills: Proficiency with Microsoft Office, Google Suite, productivity software, and medical billing systems.
• Communication: Strong written and verbal communication skills for patient and provider interactions.
• Attention to Detail: High accuracy in order entry, documentation, and compliance checks
• Problem-Solving & Conflict Resolution: Ability to resolve disputes with patients or providers professionally.
• Service Excellence: Ability to deliver on patient service excellence through relationships with patient clients and the management patient schedules.
• Work Ethic: Ability to work independently and as part of a team, typically during standard business hours (Mon–Fri, 8:00 a.m.–5:00 p.m.)
• Patient Confidentiality: Always maintain the confidentiality of patient information, in compliance with all appropriate regulations including but not limited to HIPAA.
• Work Experience: Minimum of six (6) months of health industry experience in a medical office or processing medical claims, and, minimum of six (6) months customer service experience, communicating with customers or patients to include items of a financial nature.

Training and Professional Development:

• Training:
  • Complete all internal Risen Medical training requirements to include learning relevant Medicare regulations and company Medicare compliance requirements.
  • Become proficient in Niko Health billing and management software.
  • Attend and complete all training required to fulfill role requirements.
  • Attend and participate in all video teams meetings when scheduled.

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