Order Review Specialist

Description

SUMMARY:

The DME Order Review Specialist plays a critical role in ensuring that all durable medical equipment orders are accurate, complete, and compliant before fulfillment. This position supports the DME supplier’s daily operations by reviewing physician documentation, verifying insurance coverage, and confirming that all regulatory and payer requirements are met. The specialist works closely with prescribers, patients, referral sources, and internal departments to ensure timely, compliant, and efficient order processing.

Essential Functions

• Review incoming DME orders to confirm accuracy, completeness, and compliance with Medicare, Medicaid, and commercial payer guidelines.
• Validate physician documentation (prescriptions, progress notes, face-to-face encounters, CMNs, etc.) for medical necessity and signature/date requirements.
• Ensure product selection aligns with diagnosis and payer coverage criteria.
• Communicate with physicians, referral partners, and patients to obtain missing documentation or clarify order information.
• Verify insurance eligibility, coverage, and authorization requirements for DME items.
• Collaborate with billing and authorization teams to resolve discrepancies and prevent claim denials.
• Enter order details and documentation into the company’s DME management system accurately and efficiently.
• Maintain current knowledge of payer policies, HCPCS coding, and compliance standards for DME items.
• Support internal audits, quality checks, and training initiatives to uphold compliance and accuracy.
• Adhere to HIPAA and company confidentiality policies when handling patient information.
  
  

Requirements

REQUIRED EDUCATION AND/OR EXPERIENCE:

• High school diploma or GED required, associate degree in healthcare administration, medical billing, or a related field preferred.
• 1–3 years of experience in DME, HME, or medical billing/authorization with a DME supplier or similar healthcare setting.
• Working knowledge of DME products, insurance verification, and Medicare coverage criteria required.
• Experience using DME billing or order management software (e.g., Brightree, Bonafide, Fastrack, or similar) preferred.
  
  

Preferred Education And/Or Experience

• Strong attention to detail and accuracy in data entry and documentation review.
• Solid understanding of payer documentation and coverage requirements for DME.
• Effective written and verbal communication skills with healthcare professionals and patients.
• Ability to prioritize and manage multiple orders in a fast-paced environment.
• Proficiency with Microsoft Office and EMR/DME systems.
• Strong problem-solving and organizational skills.
  
  

Position Type/Expected Hours Of Work

This is a full-time position, and hours of work and days are Monday through Friday, 8:00 a.m. to 5:00 p.m. to start, with the possibility of flex scheduling based on department needs and individual performance.

SUPERVISORY RESPONSIBILITY:This position has no supervisory responsibilities.

WORK ENVIRONMENT:This position is a fully remote position that requires routinely using standard office equipment such as computers, multiple screens, and phones.

PHYSICAL DEMANDS:The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.This is primarily a sedentary position, spending most of the workday sitting at a desk in an office setting. Specific vision abilities required by this job include both close and distance vision, color and peripheral vision, depth perception and ability to adjust focus.

TRAVEL:No travel is typically not expected for this position.

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

EEO STATEMENT:DASCO provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, DASCO complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

DASCO expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of DASCO’s employees to perform their job duties may result in discipline up to and including discharge.