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DME Customer Order Specialist- Remote

Company: Kestra Medical Technologies, Inc.
Location: Las Vegas
Posted on: January 15, 2022

Job Description:

The Kestra team has over 400 years of experience in the external and internal cardiac medical device markets. The company was founded in 2014 by industry leaders inspired by the opportunity to unite modern wearable technologies with proven device therapies. Kestra's solutions combine high quality and technical performance with a wearable design that provides the greatest regard for patient comfort and dignity. Innovating versatile new ways to deliver care, Kestra is helping patients and their care teams harmoniously monitor, manage, and protect life.

The Durable Medical Equipment (DME) Customer Order Specialist is responsible for performing all tasks and communication related to intake and processing of prescriptions and/or physician work orders, as well as patient information concerning the rental of durable medical equipment. This role regularly communicates with patients, health care providers, Team Members, Health Insurance (payor) representatives and referral sources as it relates to competently and efficiently requesting and obtaining payor prior authorizations on behalf of patients in a friendly, caring, and professional manner. Frequently, this position discusses insurance benefits, out-of-pocket costs, deductibles, and payment methods with patients. The DME Customer Order Specialist is knowledgeable in Kestra DME offerings, its features and benefits, and process to uphold its standards for excellence.


  • Coordinate with sales representatives, physician's office, and applicable internal/external personnel in regard to medical records and information needed to obtain pre-authorization and benefits upon intake of new patient referrals. Confirm medical records meet medical necessity based on applicable insurance guidelines. Promptly follow-up on patient referrals, physician prescriptions and/or physician work orders
  • Verify eligibility and benefits of patient health insurance specific to Durable Medical Equipment (DME) by contacting insurance companies by phone, accessing insurance website portals, and utilizing Kestra's medical billing software. Responsible for verification of active coverage, deductibles, accumulations, coinsurance, and pre-authorization requirements.
  • Initiate, track, and complete pre-authorizations requests, including notifying applicable parties of the determination. Assist with appeals for Prior Authorization denials.
  • Upon authorization, place orders for Durable Medical Equipment, notify, and dispatch patient product fitters.
  • Review information and/or reports to confirm scheduled fitters arrive at destination in a timely manner.
  • Review "Delivery Tickets" to confirm they were completed accurately and signed.
  • Perform data entry into medical billing software and other software (Salesforce) including patient demographics, prescribing physician's information, insurance payor information, HCPCS procedure codes, ICD-10 diagnosis codes, etc.
  • Regularly contact and communicate with Team Members, insurance companies, vendors, sales representatives, doctor's offices, practitioners, clearinghouses, billers, and other applicable companies and associates. Send updates on prior authorizations, claims, patient benefits, orders, and other information as appropriate.
  • Regularly communicate with patients to discuss their insurance benefits, out-of-pocket costs, and product payment arrangements.
  • Escalate issues within insurance carriers when not able to obtain reasonable information
  • Answer incoming phone calls to office and route messages accordingly.
  • Routinely export/import data from one software to another software.
  • Create forms through auto-populating data into custom fields.
  • Perform detailed notetaking with high accuracy on pertinent information.
  • Utilize Adobe Acrobat Pro to create and edit PDF files: insert/move/delete pages; edit/add/redact text; save meta data, create templates, export/import data through plugin, etc.
  • Consistently follow up with patients to confirm patient satisfaction
  • Accurately complete forms/applications and send out to applicable destination
  • Exercise patience and empathy when communicating with patients and customers
  • Be aware of and adapt to changes in medical regulations and processes
  • Participate in on-call and off hours coverage. Hours on-call and worked may include evenings, weekends, and holidays.
  • Adhere to Pledge of Confidentiality
  • Information regarding a patient of this company shall not be released to any source outside of this company without the signed permission of the patient. Furthermore, information will only be released internally on a need-to-know basis. All Team Members will not discuss patient cases outside the office or with anyone not employed by this company unless they are directly involved with the patient's case.

    • Passion: Contagious excitement about the company - sense of urgency. Commitment to continuous improvement.
    • Integrity: Commitment, accountability, and dedication to the highest ethical standards.
    • Collaboration/Teamwork: Inclusion of Team Member regardless of geography, position, and product or service.
    • Action/Results: High energy, decisive planning, timely execution.
    • Innovation: Generation of new ideas from original thinking.
    • Customer Focus: Exceed customer expectations, quality of products, services, and experience always present of mind.
    • Emotional Intelligence: Recognizes, understands, manages one's own emotions and is able to influence others. A critical skill for pressure situations.


      Education/Experience Required:
      • High School Diploma or GED
      • Two (2) or more years of experience with Insurance verifications, which include gathering prior authorization required documents and submitting/following-up prior authorizations requests to payors
      • Direct experience using payor portals
      • Highly accurate with pertinent information. e.g. reference #s, dates, spelling of names, ID#s, phone #s, email addresses
      • Consistently detailed oriented and thorough.
      • Advanced written and verbal communication skills, to include excellent grammar
      • Advanced reading and comprehension abilities
      • Advanced analytical skills and detail-oriented
      • Advanced multi-tasking skills
      • Advanced organizational and prioritization skills, with strong ability to meet strict deadlines
      • Proficient typing skills
      • Proficient with Microsoft Word, Microsoft Outlook, Adobe Acrobat, general internet research, and beginner knowledge of Microsoft Excel
      • Familiarity with PDF editing

        • Experience with HCPCS procedure codes and ICD-10 codes

          • Remote, yet fast paced work environment
          • Noise level typical of an open office environment
          • Drug-free

            • Frequent repetitive motions that may include wrists, hands and/or fingers, such as keyboard and mouse usage
            • Frequent stationary position, often sitting for prolonged periods of time
            • Occasional bending and stooping
            • Occasional lifting up to 20 pounds

              • Occasional travel, less than 5%

Keywords: Kestra Medical Technologies, Inc., Las Vegas , DME Customer Order Specialist- Remote, Other , Las Vegas, Nevada

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