DME Medical Records

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Description

Northern Pharmacy & Medical Equipment is looking for a detail-driven and motivated DME Medical Records Review Specialist to join our growing team. In this role, you will play a vital part in ensuring patients receive the equipment and supplies they need while maintaining the highest standards of documentation accuracy, regulatory compliance, and reimbursement integrity.

If you enjoy solving problems, working with healthcare professionals, and being part of a fast-paced team that supports patient care behind the scenes, this is an excellent opportunity to grow your career in healthcare operations.

Requirements

As a DME Medical Records Review Specialist, you will help ensure that medical documentation meets all necessary regulatory and insurance requirements so patients can receive the equipment and supplies they need without delays.

Your responsibilities will include:

• Reviewing and auditing medical records to confirm documentation supports medical necessity for durable medical equipment and supplies

• Ensuring compliance with Medicare, Medicaid, and commercial insurance guidelines

• Identifying missing or incomplete documentation and proactively following up with physicians, clinicians, and office staff

• Securing required documentation to support accurate billing and timely reimbursement

• Entering and maintaining accurate patient data in EMR and billing systems

• Reviewing documentation for initial qualification and continued medical need for DME equipment

• Interpreting and applying DX, CPT, and HCPCS codes appropriately

• Troubleshooting documentation issues and independently resolving complex cases

• Maintaining strict compliance with HIPAA and regulatory standards

• Communicating professionally with internal teams, referral sources, and healthcare providers

• Supporting operational efficiency by maintaining consistent attendance and reliability

Required Qualifications

• High School Diploma or GED

• Minimum 1 year of experience in DME, medical records review, or a related healthcare role

• Strong understanding of medical terminology

• Knowledge of Medicare, Medicaid, and commercial insurance documentation requirements

• Familiarity with DX, CPT, and HCPCS coding

• Excellent communication and organizational skills

• Strong computer and data entry skills

• Ability to prioritize tasks and work efficiently in a fast-paced environment

• Detail-oriented with strong problem-solving abilities

Preferred Qualifications

• Associate degree or related college coursework

• Experience using Brightree software

• Previous experience in insurance verification or medical billing

• DME compliance, audit, or documentation review experience

Work Environment

• In-person position located in Baltimore, Maryland

• Collaborative and fast-paced healthcare operations environment

• Supportive team culture with opportunities to develop industry expertise

Why Join Us?

At Northern Pharmacy & Medical Equipment, we are committed to supporting patients, providers, and our community by delivering high-quality service and operational excellence. Our team members are valued for their expertise, dedication, and contributions to improving patient outcomes.

Northern Pharmacy & Medical Equipment is proud to be an Equal Opportunity Employer.

We celebrate diversity and are committed to creating an inclusive environment for all employees regardless of race, color, religion, sex, national origin, age, disability, veteran status, or any other protected classification under applicable law.