Durable Medical Equipment (DME) Advocate

Overview

Durable Medical Equipment (DME) Advocate 

Remote position for South Carolina Residents Only!

Position Summary:The Durable Medical Equipment Advocate is a non-clinical position that assists the clinical Care Coordinator (CC) staff in supporting members with chronic clinical conditions for the Medically Complex Children’s Waiver (MCCW) program in South Carolina.

Responsibilities

Essential Duties and Responsibilities:

• Documents information into the SCDHHS electronic health record for all contacts with members and/or their authorized representative, doctors’ office staff, or other stakeholders• Act as a liaison between other employees, providers, and participant families.• Accurately log DME information for tracking purposes on internal databases.• Communicate with members and their authorized representatives, to ensure information is up to date.• Conduct research and initiate outreach to members, authorized representatives, DME providers, physicians, and other stakeholders to coordinate care, schedule services, process orders, and gather all necessary information to assist with requested DME needs.• Consistently follows up with all stakeholders until final resolution is achieved.• Collaborates with external partners, Care Coordinators, and Care Advocates to deliver exceptional service to participants and their authorized representatives.• Accurately prepares and maintains referral, denial, cost sheet, and any other supportingdocumentation for DME orders.• Monitors participants eligibility status• Receives information regarding participant via facsimile, telephone, email, and text message.• Will have access and manage PHI in accordance with federal and state requirements (HIPAA, HITECH).

Supervisory Responsibilities:   None

Qualifications

Competencies:

• Strong organizational and interpersonal skills
• Excellent written and verbal communication skills
• Detail oriented
• Ability to multi-task and work independently
• Strong competency in Microsoft Office products including Word and Excel
• Demonstrates exceptional customer service skills

Qualifications:

Education and Experience:

• A high school diploma or equivalent is required
• A minimum of two (2) years of work experience in a medical office setting
• Knowledge of medical terminology is required
• Prior DME experience preferred but not required
• Demonstrates strong data management skills, including organizing, maintaining, and retrieving information efficiently
• Strong customer service/telephone skills
• Ability to multi-task and work independently while exercising initiative, problem-solving, and decision-making capabilities
• Knowledge of Medicaid guidelines and processes preferred

Certificates, Licenses, Registrations: None Required

Computer Skills:

• Proficiency using software programs such as Microsoft Word, Excel, Outlook, and Adobe

Environmental Factors/Physical Demands:

Work is performed in an office environment. While performing the duties of this job, the employee is regularly required to have the ability to maintain active customer and employee communication; access, input and retrieve information from the computer system; enter alpha-numeric data into a computerized system often while listening on the telephone. May be subject to repetitive motion such as typing, data entry and sustained visual attention to monitors. May be subject to bending, reaching, kneeling, stooping and lifting up to thirty (30) pounds.

Other Responsibilities:

This job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee. Duties, responsibilities, and activities may change at any time with or without notice.

• Adheres to the policies and procedures of Community Health Solutions
• Maintains strict confidentiality of client, company, and personnel information
• Demonstrates a strong commitment to the mission and values of the organization
• Adheres to company attendance standards
• Performs other duties as assigned by the Director of Care Advocate Programs
• Completes all annual training assigned by the deadline for completion
• Will demonstrate successful completion and compliance with all policies and procedures, to be assessed during quarterly performance reviews
• Criminal background, OIG, and South Carolina Exclusion list checks must remain in good standing.
• Will abide by the Ethical Code of Conduct set forth by the company, to be reviewed and signed yearly.

HIPAA and Data Privacy Obligations:

Due to the nature of this position and its involvement with the Medically Complex Children’s Waiver Program, you will have access to Protected Health Information (PHI) governed by the Health Insurance Portability and Accountability Act (HIPAA) and other applicable federal and state privacy laws.

This role has direct access to Protected Health Information (PHI). The following rules are non-negotiable:

• Absolute confidentiality: Employees must not disclose PHI to unauthorized individuals under any circumstances.
• Secure environment: A private, locked workspace must be maintained to prevent exposure of PHI to family members, visitors, or others.
• Company-approved technology only: All work must be performed on secure, company-issued devices using encrypted connections (VPN required).

You will be required to complete HIPAA training upon hire and annually thereafter. Any breach of confidentiality or unauthorized disclosure of patient information may result in disciplinary action up to and including termination and may carry legal consequences under state or federal law.

Employment At-Will:

Please note that employment in South Carolina is at-will, and either you or CHS may terminate the employment relationship at any time, with or without cause or notice. Nothing in this letter creates a contract for continued employment.

Drug Free Work Place:Premier Family of Companies and its affiliates is committed to providing a safe, healthy, and productive work environment for all employees. To achieve this, CHS maintains a smoke-free and drug-free workplace. Candidates who receive a conditional offer must complete a pre-employment drug screen.  Random and post-incident testing may also be required.

Confidentiality:You agree to maintain the confidentiality of all proprietary and non-public information obtained during your employment. This includes, but is not limited to, company records, financial data, client and vendor information, business strategies, and any other information not generally known outside the Company. You may not use or disclose such information during or after your employment, except as required in the performance of your duties. All company property and materials must be returned upon separation of employment.

Position Title: DME AdvocateReports to: Director of Care AdvocatesSBU: Community Health Solutions of America FLSA Status: Non-Exempt/Hourly – Full Time Location: Remote – Must reside in the State of SC

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