Chicago, IL · Remote
$40 - $42/hr
This is a fully remote role but candidates must have a valid RN license in Illinois*** Position ... Assess and analyze clinical service requests (e.g., surgeries, outpatient therapies, DME) using ...
Quick apply
Chicago, IL · Remote
$40 - $42/hr
This is a fully remote role but candidates must have a valid RN license in Illinois*** Position ... Assess and analyze clinical service requests (e.g., surgeries, outpatient therapies, DME) using ...
A Remote DME (Durable Medical Equipment) job involves processing orders, verifying insurance coverage, and assisting patients with medical equipment needs while working from home. Responsibilities may include coordinating with healthcare providers, ensuring compliance with regulations, and providing customer support. This role requires knowledge of medical billing, insurance policies, and durable medical equipment. Strong communication and attention to detail are essential skills.
A Remote DME Coordinator is primarily responsible for processing orders for durable medical equipment, communicating with healthcare providers and insurance companies, and ensuring all necessary documentation is accurate and compliant. Daily tasks typically include verifying patient insurance coverage, obtaining prior authorizations, updating records in management systems, and coordinating deliveries with vendors. You may also assist patients directly with questions about their equipment or insurance coverage. Consistent collaboration with both internal teams and external partners is a key part of the role. This position is often fast-paced and requires strong attention to detail to ensure timely and accurate service for patients.
To thrive as a Remote DME (Durable Medical Equipment) Coordinator, you need a solid understanding of medical terminology, insurance processes, and DME protocols, often supported by experience in healthcare administration or a related certification. Familiarity with electronic health records (EHR), DME management software, and insurance verification systems is essential. Strong organizational skills, clear communication, and attention to detail are key soft skills that help in managing patient needs and collaborating with providers and suppliers. These skills ensure efficient, accurate equipment provision while supporting patient care and compliance with industry regulations.
The most popular types of Dme jobs in Chicago, IL are:
For Remote Dme jobs in Chicago, IL, the most frequently searched job titles are:
The top searched job categories for Remote Dme jobs in Chicago, IL are:
Cities near Chicago, IL with the most Remote Dme job openings:
AltaStaff is a staffing agency currently looking for a Care Review Clinician I to work with our Managed Care Client!
Pay Rate: $40 - 42.00 hourly
Schedule: Monday-Friday 9am-5:30pm CST, Rotating Saturday 7-11am CST, Rotating Holidays
***This is a fully remote role but candidates must have a valid RN license in Illinois***
Position Purpose: Care Review Clinician works with the Utilization Management team primarily responsible for medical necessity/utilization review aimed at providing members with the right care.
Assess and analyze clinical service requests (e.g., surgeries, outpatient therapies, DME) using evidence-based MCP/MCG criteria.
Verify member benefits and eligibility and Process prior authorization determinations within regulatory timelines
Collaborate with multidisciplinary teams
Completes/reviews Authorizations, reviewing faxes that can be 50-100 pages long
Will be expected to manage 25-30 cases successfully daily.
Should be able to quickly and accurately determine whether the criteria meet medical necessity.
Provides daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review.
Assesses services for Molina Members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and
guidelines.
Provides concurrent review and prior authorizations (as needed) according to Molina policy for Molina members as part of the Utilization Management team.
Additional duties assigned
Education/Experience:
RN license in IL required
Must have 2+ years clinical practice experience (hospital, case management, utilization management)
Must have 1-3+ years of hospital or medical clinic, utilization review
Must have 2-3 years of Prior Authorization OR Med-Surg experience; Familiarity with Inpatient Medical Necessity
Must have solid experience within a clinical setting as RN’s must be able to use their knowledge to extrapolate key information during the authorization process
If you've applied and would like to view your application status, please visit: https://altastaff.zenople.com/login/ALTA
AltaStaff is an Equal Employment Opportunity Employer. We provide equal employment opportunities to all qualified applicants for employment without regard to age, race, color, creed, religion, sex, marital status, national origin, ancestry, citizenship, disability, veteran status, sexual orientation, or any other protected status, in accordance with applicable federal, state, and local laws.
#ZR
INDLP
Sourced by ZipRecruiter
51 - 200 Employees
Chicago, IL, US
2007
