Medicare Funding Specialist
Current• Ensure all client information and documentation is complete and accurate and that medical records are saved in accordance to industry standards.• Ensures proper assignment of ICD10 coding and HCPC coding along with estimated pricing and reimbursement of equipment.• Verifies client benefits and coverage for equipment and communicates benefit information to the client.• Gathers documentation required by payer in accordance with Medicare guidelines, including but not limited to: proper prescriptions, mobility evaluations, face to face examinations, letters of medical necessity, RTS evaluation information and forms required by payer.• Clearly identifies documentation required by payer and payer requirements.• Communicates with clinicians in an effort to secure compliant documentation required by payer.• Ensures all documentation is compliant and updated prior to purchase and/or delivery of equipment.• Clearly communicates delivery expectations to client and branch staff or RTS/ATP.Understands CMS guidelines for Original Medicare and Managed Medicare for obtaining prior authorization funding for Original Medicare and Managed Medicare plans
