Intake Specialist (DME Operations)
Palatine, IL
Full Time
Mid Level
Are you a DME expert who understands that "clean claims" start with excellence? European Service at Home, Inc. is seeking a high-caliber Intake Specialist to serve as our Clinical Liaison and Execution Lead. In this role, you aren’t just processing orders—you are the "Engine" of our workflow. You will bridge the gap between a physician’s clinical intent and the complex world of insurance coding. Your goal is to ensure every piece of equipment dispensed is clinically sound, fully documented, and selected to maximize business profitability. As the Intake Specialist, you have the authority to drive profitability and the clinical oversight to ensure our patients receive the best possible care. You will work within a supportive team dedicated to quality improvement and operational excellence.
Key Responsibilities
Qualifications & Requirements
Key Responsibilities
- Lead Processing: Own the end-to-end processing of all incoming leads. Conduct thorough clinical triage following initial assistant verification to ensure the equipment perfectly matches the patient's medical condition.
- Profit-Driven Product Selection: Utilize our Internal Master Product Guide to recommend products that satisfy clinical necessity while securing the best profit margins for the organization.
- Physician Collaboration: Act as the primary point of contact for doctors. Conduct peer-to-peer calls to clarify orders, secure complex clinical notes, and educate referral sources on Medicare/Payer requirements.
- Coding & Documentation Excellence: Write comprehensive medical necessity narratives, prepare CMNs, and assign accurate HCPCS Level II and ICD-10 codes.
- Technical Auditing: Utilize DMEWorks to perform technical audits, ensuring modifiers (RR, NU, RA, KX) are applied correctly for first-pass clean claim success.
- Prior Authorization Management: Lead the submission of complex authorization requests via HFS/MEDI portals.
- Leadership & Oversight: Exercise professional judgment to halt deliveries if medical necessity is unsupported. Delegate front-end data entry to the DME Assistant while providing critical feedback loops to the DME Manager
- Analytical: You enjoy "Root Cause Analysis"—identifying why a claim was rejected and implementing a permanent fix.
- Organized: You can remain flexible and function well in high-pressure, stressful situations.
- Professional: You maintain a neat appearance and a courteous, caring atmosphere with staff, patients, and vendors alike.
- Ethical: You are committed to the highest standards of client confidentiality and ethical business practices.
Qualifications & Requirements
- Education: High school diploma or equivalent (required).
- Experience: Previous experience in Durable Medical Equipment (DME/HME) operations or specialized training is highly preferred.
- Communication: Exceptional English verbal and written skills (Peer-to-Peer experience is a plus); additional languages are a benefit.
- Regulatory: Must possess a valid driver’s license and current vehicle insurance.
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