Job Information
Children's Hospital Boston Care Management Associate in Boston, Massachusetts
75130BRJob Posting Title:Care Management AssociateDepartment:Medicine-GI/NutritionAutoReqId:75130BRStatus:Full-TimeStandard Hours per Week:40 Job Posting Category:AdministrationJob Posting Description: General Summary
The DME Coordinator will be responsible for coordinating all aspects of the patient referral process for enteral nutrition and supplies; including working with insurance companies, durable medical equipment companies and patient families for delivery of products and supplies. The coordinator will work closely with clinical staff and provide accurate and timely non-clinical administrative support to facilitate ongoing patient care needs.
Principal Duties and Responsibilities Performs the duties and responsibilities as following:
Answering, screening and routing phone and email inquiries from patients, families, clinical staff and external durable medical equipment companies
Recording and documenting worklist of requests to ensure timely submission, approval, delivery
Reviewing daily work assignments and prioritizing to ensure critical requests are addressed
Facilitating all new and existing enteral nutrition patient referrals
Corresponding with insurance and durable medical equipment companies to determine medical benefit, identify contracted companies and ensure enteral nutrition supplies are supported
Accurately completing necessary insurance related documents including HCPCS Codes
Printing prescriptions and clinical notes to support advocacy for medical necessity
Electronically submitting related documents to durable medical equipment companies adhering to HIPPA guidelines and policies
Assisting with timely and effective follow up communications with durable medical equipment companies, the patient family and providers
Facilitating change from one durable medical equipment company to another as needed
Continuously gathering information and keeping up to date with evolving insurance guidelines, requirements and formularies
• Actively promoting and fostering excellent relations with durable medical equipment representatives
Demonstrating high-level critical thinking and problem resolution skills.
To qualify, you must have:
High school diploma required. Some college or occupationally-specific education/training preferred.
Minimum of 2 years of experience in a high volume administrative role with an emphasis on problem resolution among multiple internal and/or external parties. At least 1 of the 2 years should be in a healthcare or health insurance setting
Strong organizational skills and attention to detail.
An ability to manage multiple tasks within time constraints, as well as the ability to solve problems but with a keen sense of when to escalate for appropriate resolution.
Office/Site Location:BostonRegular, Temporary, Per Diem:Regular Remote Eligibility :Part Remote/Hybrid