DME Specialist

Position: DME Specialist

Location: Fort Worth, TX

Job Summary

The DME Specialist is directly responsible for providing quality technical support services on various DME supported software applications and for keeping management aware of customer problems and situations which the representative cannot resolve. The representative assists in all areas of reconciliation services provided by FDS to its customers. These services will include verification of 835 enrollments with participating payor’s, posting of payments to appropriate claims, researching claims with payers and other vendors as required, and reporting services back to the customer.

Principal Duties and Responsibilities

  • Coordinate and verify with FDS enrollment personnel that subscribing customers have been enrolled in electronic 835 remittance programs.
  • Notify FDS 835 contract enrollment of new third-party payor’s that appear on claim data for contract pharmacies.
  • Monitor daily reporting of 835 files received and review payment exceptions in the reconciliation portal.
  • Responsible for entering and updating accurate records for paper EOBs received for non-electronic 835 remittance forms.
  • Responsible for verifying payment information received from subscribing customer is properly entered into the reconciliation portal and the appropriate matching claims are relieved from the outstanding third-party balances for both paper and electronic remittance advices.
  • Educate and train subscribing customers on pharmacy and DME reconciliation programs and reports available for their on-line review.
  • Talk with customers and/or potential customers about DME services.
  • Enters alphabetic, numeric, or symbolic data from customers source documents into computer following format displayed on the screen.
  • Must maintain knowledge of DME products and Medicare policies and learn product updates and enhancements.
  • Ability to quickly and accurately answer and route incoming calls to appropriate parties.
  • Assists users to learn procedures followed and the source of an error. Participates in phone calls and/or emails with users to troubleshoot problems.
  • Responsible for notifying management of customer complaints.
  • Exposure to confidential corporate and customer information must maintain absolute confidentiality and comply with HIPAA guidelines.
  • Prepare and maintain spreadsheets and reports as necessary.
  • Compose letter and memos to appropriate third-party payors and subscribing customers.
  • Keep cases updated in NetSuite system in a timely manner.
  • Assist customers in designing necessary accounting protocols for submission of payment and claim posting activities.
  • Maintain satisfactory attendance in accordance with policy
  • Other duties as may be assigned.

 

        Skills and Abilities

  • Ability to communicate and understand DME Medicare policies and related terminology.
  • Excellent computer skills, including Word and Excel in a Microsoft Windows environment.
  • Effective oral and written communication skills.
  • Excellent interpersonal skills.
  • Excellent organizational skills.
  • Must be able to identify and resolve problems in a timely manner.
  • Must be able to gather and analyze information skillfully.
  • Manage difficult or emotional customer situations, respond promptly to customer needs.
  • Treat people with respect, uphold organizational values
  • Prioritize and plan work activities, use time efficiently
  • Self-starter, asks and offers help when needed, takes independent actions to assist
  • Excellent attendance and punctuality required

 

Experience

  • Two years related experience and/or training; or equivalent combination of education and experience.
  • Typing 40 wpm.
  • 10-key by touch.

Word Processing, Spreadsheets, Windows

Language Skills

  • Ability to read, analyze, and interpret general business periodicals.
  • Ability to write reports, business correspondence and procedure manuals.
  • Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.

Mathematical Skills

  • Ability to add, subtract, multiply and divide.  Ability to calculate figures and amounts such as discounts.

Reasoning Ability

  • Ability to solve practical problems and deal with a variety of concrete variables.
  • Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

Certificates, Licenses, Registrations

  • Must have valid driver’s license.
  • Must have reliable transportation.

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. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
  • While performing the duties of this job, the employee is regularly required to stand; walk; sit; use hands to finger, handle, or feel; and talk or hear.
  • The employee frequently is required to reach with hands and arms; climb or balance; stoop, kneel, crouch, or crawl.
  • The employee must occasionally lift and/or move up to 25 pounds.
  • Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus.

FDS, Inc. IS AN EQUAL OPPORTUNITY EMPLOYER

Please submit resume to: jobs@fdsrx.com