As our CMN Coordinator, you'll be the bridge between our clinical team, physicians, and insurance providers. Your work will ensure that patients receive their prescribed respiratory equipment without necessary delays. By managing Certificates of Medical Necessity with precision and compassion, you'll help remove administrative barriers so patients can focus on healing and breathing easier.RESPONSIBILITIES INCLUDE (BUT ARE NOT LIMITED TO):Review incoming CMNs for completeness, accuracy, and compliance with payer and regulatory requirements.Communicate with physicians' offices to obtain missing information, signatures, or clarifications. Enter and maintain accurate patient and order data in our electronic medical records system.Track CMN status to ensure timely submission and approval by insurance providers.Collaborate with respiratory therapists, billing specialists, and customer service teams to expedite patient care.Responsible for CMN Report:Making sure every CMN that is signed is being followed up on weeklyFollow-up documentation is being done on all CMN's not signedStay current on Medicare, Medicaid, and private insurance guidelines related to respiratory equipment coverage.Maintain organized documentation for audits and compliance reviews. Assist with duties in our Prior Authorization department, processing order intake as well as assisting in the billing department. Regular and reliable attendanceOther duties as assigned REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES: Experience in healthcare administration, DME (Durable Medical Equipment), or medical billing preferred.Knowledge of CMNs, insurance verification, or Medicare/Medicaid guidelines is a plus.Strong attention to detail and ability to work with sensitive Patient information (HIPAA compliance).Excellent communication skills for working with physicians, patients, and internal teams.Proficient working knowledge with EMR systems and MS Office Suite.A problem-solving mindset and ability to manage multiple priorities under tight deadlines. High school diploma or equivalentMaintain a professional appearance and demeanor.Excellent organizational and time management skillsSCHEDULE: Monday-Friday, subject to change based on the needs of the businessPHYSICAL REQUIREMENTS & WORKING CONDITIONS: While performing the duties of this job, the employee is regularly required to sit, use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; and talk or hear. The employee is occasionally required to stand, walk, stoop, kneel, crouch, or crawl.The employee must be able to operate specific equipment or tools and work with specific computer software.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 the ability to adjust focus.KUBAT HEALTH CARE IS AN EQUAL OPPORTUNITY EMPLOYERThe statements herein are intended to describe the general nature and level of work being performed by employees and are not to be construed as an exhaustive list of responsibilities, duties, and skills required of personnel so classified. Furthermore, they do not establish a contract for employment and are subject to change at the discretion of the employer.
Job Posted by ApplicantPro