Jobs · Customer Service · Florida

DME Referral Coordinator

Vaco by Highspring · Miramar, FL · 1 mo ago
On-siteCustomer Service$20/hrFull-time

About the role

The Home Health Referral Coordinator processes, evaluates, and coordinates patient referrals for Home Health services, ensuring patients receive appropriate care based on their medical needs. This role involves timely, accurate, and compliant referral management while facilitating communication between healthcare providers, patients, and payers. The coordinator ensures proper coordination of all applicable and appropriate Home Health services across all contracted health plans.

Responsibilities

  • Evaluate and process patient referrals for Home Health services
  • Ensure timely and accurate communication with healthcare providers, patients, and payers
  • Facilitate proper coordination of Home Health services across various health plans
  • Determine and document appropriate compensation for referrals
  • Manage and verify insurance authorizations for Home Health services
  • Collaborate with healthcare providers to ensure compliance with medical necessity guidelines and payer requirements
  • Communicate with patients regarding their Home Health services and insurance coverage
  • Ensure adherence to relevant state and federal regulations

Requirements

  • Experience in healthcare referral processing or utilization management
  • Strong knowledge of DME categories, medical necessity guidelines (e.g., LCD/NCD), and payer authorization procedures
  • Bilingual Spanish preferred
  • Excellent communication skills
  • Solid understanding of home health services
  • Comprehensive knowledge of applicable state and federal regulations
  • Prior experience in Home Health, particularly with enteral supplies

Qualifications

  • Experience in healthcare referral processing or utilization management
  • Strong knowledge of DME categories, medical necessity guidelines (e.g., LCD/NCD), and payer authorization procedures
  • Bilingual Spanish preferred
  • Excellent communication skills
  • Solid understanding of home health services
  • Comprehensive knowledge of applicable state and federal regulations
  • Prior experience in Home Health, particularly with enteral supplies

Skills

  • Strong communication skills
  • Attention to detail
  • Understanding of home health services
  • Knowledge of applicable state and federal regulations
  • Experience with enteral supplies

Benefits

  • Medical, dental, and vision benefits
  • Company 401(k) retirement plan

Pay

The salary range for this role is noted in the job posting. The individual may also be eligible for discretionary bonuses.

Schedule

The schedule for this role is 9am-6pm Monday - Friday.

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