National Seating & Mobility

General

• Coordinate with the Funding Manager, Funding Supervisor, Branch Manager, Rehabilitation Technology Supplier, and office support personnel to complete operational procedures
• Manage the complete funding transaction cycle, including coding and pricing, gathering documentation, submitting funding packages, and collecting payer decisions
• Manage transaction cycle time from Ready to Process to Final Funding Approval
• Obtain missing demographics and ensure client information and minimum documentation requirements are accurate in work orders
• Verify client benefits and coverage and communicate benefit information to clients
• Gather and review prescriptions, Letters of Medical Necessity, RTS evaluation information, price lists, and required forms
• Communicate with physicians, therapists, RTSs, clients, branch personnel, and referral sources to secure required documentation and information
• Investigate and update payer requirements in the UPD
• Maintain client communication and notify clients of financial responsibility when applicable
• Follow up with payer sources to obtain timely authorization through the Funding Work Queue
• Request and obtain approval for work order credit exceptions
• Conduct pre-purchase quality assurance and pre-delivery verification
• Coordinate with other funding areas and complete Action Required queue tasks
• Complete assigned duties and continuing education requirements with minimal supervision

Funding Specialist II

Reimbursement Specialist

• Perform timely and accurate follow-up on claims to payers and patients
• Prepare and submit timely and accurate rebilled claims
• Submit initial billed secondary and tertiary claims to payers
• Enter demographic data into billing and collections software
• Generate claims for electronic and/or hard-copy submission
• Generate Missing Information Requests (MIR)
• Identify variances between booked revenue and expected reimbursement
• Facilitate accurate claim reimbursement according to contracts and state and federal law
• Identify and report violations of NSM Credit Policy
• Collect and document payer-specific claims processing rules, practices, and guidelines
• Support department and organizational policies and procedures
• Perform other duties as assigned

• Coordinate with the Funding Manager, Funding Supervisor, Branch Manager, Rehabilitation Technology Supplier, and office support personnel to complete operational procedures
• Manage the complete funding transaction cycle, including Coding & Pricing, gathering documentation, submitting funding packages, and collecting payer decisions
• Manage transaction cycle time from Ready to Process to Final Funding Approval
• Obtain missing demographics and ensure client information and Minimum Documentation Requirements are correct in the work order
• Verify client benefits and coverage and communicate benefit information
• Gather and review prescriptions, Letters of Medical Necessity, RTS evaluation information, price lists, and required forms
• Communicate with physicians, therapists, RTSs, clients, branch personnel, and referral sources to secure documentation and information
• Investigate and update payer requirements in the UPD
• Maintain client communication, including notification of financial responsibility
• Follow up with payer sources to obtain timely authorization through the Funding Work Queue
• Request and obtain approval for work order credit exceptions
• Conduct pre-purchase quality assurance and pre-delivery verification
• Coordinate with other funding areas and complete Action Required queue tasks
• Perform related duties assigned by the Funding Manager or Funding Supervisor
• Complete continuing education requirements and maintain regular, predictable attendance