Medical Documentation Specialist - Onsite/Hybrid position

GEMCORE’s continued success has earned us national recognition with Inc. Magazine’s list of America’s Fastest-Growing Companies and with the Cleveland Plain Dealer as a Top Workplace six years running! We are looking for qualified candidates who share our enthusiasm and drive for winning and want to be part of our caring culture.

About the role

Edwards Health Care Services (EHCS), a division of GEMCORE, is a well-established and growing national direct-to-home medical supply provider. We are seeking a highly motivated Diabetes Documentation Specialist to join our high-energy team. The primary role is to obtain documentation directly from physician offices for the purpose of qualifying a customer for prescribed supplies and maintaining compliance with Medicare, Medicaid, and commercial insurances. This is a hybrid remote position based in Livonia, MI.

Responsibilities

• Obtain and review medical documentation including certificates of medical necessity, pharmacy prescriptions, and lab work.
• Develop and maintain positive relationships with medical offices.
• Communicate with customers on issues relating to documentation and missing information.
• Data entry of updated customer account information for claim processing.
• Be knowledgeable of healthcare products, Medicare requirements, and various types of insurance coverage to determine customer eligibility.
• Make outbound calls to physician offices to obtain all documentation and required forms.
• Fax forms or documents for completion by prescribing doctors.

Requirements

• Self-starter with the ability to work independently to achieve desired results.
• Clinical background helpful but not necessary.
• Efficient in Microsoft Outlook and Excel.
• Good organizational skills and multitasking ability.
• Excellent telephone skills required.
• Word processing ability at a minimum of 30 WPM.
• Good cognitive reasoning ability.
• Detailed and thorough work orientation.
• Minimum 1-2 years experience in a consumer service organization or healthcare environment.
• High School Diploma or GED Equivalent.

About Edwards Health Care Services, Inc.

Edwards Health Care Services, Inc. (EHCS) is a national direct-to-home medical supply provider of high-quality medical and diabetes products that support the needs of individuals with diabetes and other conditions. For over 25 years, EHCS has been lighting the way to better health by providing customers an easier way to have products delivered directly to their door. By partnering with healthcare professionals, product manufacturers, and a large network of government and private insurers, EHCS prides itself on personalized customer service and a simplified, seamless order process for every customer…every time!

About GEMCORE

GEMCORE, a family of companies headquartered in Hudson, Ohio—Edwards Health Care Services, GEMCO Medical, GemCare Wellness, and GEM Edwards Pharmacy—offers a core set of healthcare solutions by partnering with manufacturers, providers, employer groups, insurance groups, and patients to deliver high-quality healthcare products and innovative services to proactively better lives.

Schedule

Full-time, non-exempt position. Schedule is 8:15 AM - 5:00 PM, Monday through Friday.

Benefits

• Employer-paid vacation.
• Medical, dental, and vision insurance.
• Life, short-term, and long-term disability insurances.
• 401K Retirement Savings Plan.
• Ongoing training and development.