DME Intake Referral Specialist

ACU-Serve delivers billing solutions to HME (Home Medical Equipment) providers, giving them the freedom to grow their business while collecting more, faster. ACU-Serve has helped HME businesses cut through the complexity of an ever-transitioning billing process while becoming a trusted partner for continued growth. Clients routinely show faster collections, higher revenue and dramatically reduced management and staffing problems. ACU-Serve incorporates HME workflow, Medicare, Medicaid and Private Payer knowledge, and billing and collections experts into a single service on an Internet-based technology platform. The result is faster payments, higher revenue collection rates, and less management and staffing headaches. Unlike traditional billing service models, ACU-Serve provides HME clients with a new level of control, flexibility, information access, and billing expertise. ACU-Serve functions as an integral part of the HME office staff, not a remote third party billing vendor.

Position Overview
The Enteral Nutrition Intake Specialist is responsible for ensuring excellence in the intake, qualification, and ordering process for durable medical equipment (DME) and home medical equipment (HME) products, supplies, and services. This role involves direct communication with clients, patients, providers, and referral sources, providing first-line support for the intake and processing of various medical equipment and nutritional supplies orders.

Key Responsibilities

• Maintain a comprehensive understanding of billing, documentation, and reimbursement guidelines (Medicare, Medicaid, third-party, and contracted payers).
• Receive and process inquiries, escalations, and referral requests via phone, fax, email, vendor portals, and task systems.
• Contact patients to confirm receipt of referrals, verify demographic information, and ensure eligibility.
• Enter patient data into the software system, create sales orders for equipment and supplies, obtain prior authorizations, and ensure all medical documentation is filed accurately.
• Process referrals promptly and accurately to enhance patient satisfaction and optimize client revenue.
• Gather necessary documentation based on payer requirements, standard operating procedures, and compliance programs.
• Communicate with patients when documentation does not meet payer guidelines, providing updates and offering alternative options.
• Advise providers on equipment and supply prescriptions to ensure appropriate documentation and order requirements are met.
• Maintain detailed progress notes on all aspects of the intake process.
• Address client, patient, and provider concerns, coordinating corrective action when necessary.
• Set up new referring providers in the billing system and verify licensure.
• Answer incoming calls and return voicemails professionally and promptly.
• Participate in quality reviews and achieve performance goals set by leadership.
• Maintain the confidentiality of patient health information.
• Provide exceptional customer service to clients, patients, and providers through friendly, caring, and informative interactions.

Experience & Requirements

• Minimum of 1 year of experience with Durable Medical Equipment intake processes, including insurance verification, Enteral Nutrition requirements, and prior authorization requests.
• Knowledge of billing requirements for Medicare, Medicaid, and commercial payers, and the qualifications necessary for coverage of prescribed equipment.
• High school diploma or GED required.
• Experience with Brightree DME Billing platform is a plus.
• Strong proficiency in MS Office Suite of Products including MS Word and MS Excel.
• Excellent attention to detail and ability to work in a fast-paced, task-oriented environment.
• Self-motivated and results-oriented with the ability to complete tasks efficiently and independently.
• Proven ability to suggest process improvements based on current procedures.
• Excellent problem-solving skills, with the ability to manage crises calmly and professionally.
• Ability to work effectively with diverse personalities and maintain confidentiality in line with HIPAA guidelines.

Skills & Competencies

• Personal Accountability: Takes responsibility for actions, decisions, and outcomes.
• Critical Thinking & Decision-Making: Applies analytical skills to make informed decisions.
• Effective Communication: Clearly conveys information in written and verbal form.
• Initiative: Proactively assesses situations and takes independent action.
• Interpersonal Skills: Builds and maintains strong professional relationships.
• Active Listening: Fully understands and responds appropriately to others.
• Planning & Organizing: Manages time and resources efficiently.
• Teamwork: Collaborates effectively with others to achieve common goals.

Education

• High school diploma or GED required.

ACU-Serve is an equal opportunity employer and is committed to providing a workplace that is free of discrimination of all types and promotes diversity, inclusion, and respect. We prohibit discrimination and harassment of any kind based on race, color, sex, gender, religion, creed, sexual orientation, national origin, age, disability, genetic information, pregnancy, veteran status, or any other protected characteristic as outlined by federal, state, or local laws. This policy applies to all employment practices within our organization. ACU-Serve makes hiring decisions based solely on qualifications, merit, and business needs at the time.

Originally posted on Himalayas