This job was posted by https://idahoworks.gov : For more information, please see: https://idahoworks.gov/jobs/2206880

Norco is currently seeking an individual to fill our QualificationSpecialist Position on the Complex Mobility Team. The QualificationSpecialist ensures that medical documentation is accurate and gathered in an efficient and timely manner for all orders. Other responsibilities include, but are not limited to:

• Have knowledge of the documentation requirements for the payers and product categories for which Norco provides services
• Have knowledge of insurance company policy manuals, fee schedules, and contracts
• Perform Insurance Verification
• Gather medical documentation required to meet specific insurance company\'s guidelines
• Submit and obtain insurance prior authorizations via fax, online portal entry, mail, etc for equipment prior to delivery whenever possible
• Review documentation to assure pay coverage criteria is met when a prior authorization cannot be obtained from the insurance company
• Follow up with therapists and physicians when DWOs, DPDs, chart notes, and LMNs are not received per Norco protocol
• Stay abreast of industry updates and Medicare changes
• Perform other tasks as assigned or necessary