Funding Specialist Lead - South Region

Coordinates with the Division Funding Director, Funding Manager, Funding Supervisor, Branch Manager, Rehabilitation Technology Supplier (RTS), and other office support personnel to ensure all operational procedures are completed in accordance with company policy and within expected time frames. Responsible for the thorough review of orders to ensure accuracy and providing education to Funding Specialists when errors are identified.

At all levels, working at National Seating & Mobility provides the opportunity to directly impact our client’s lives by giving them self-reliance and independence. Our teams are comprised of passionate individuals, dedicated to providing the best care to each client. We focus on abilities by leveraging technology and creating mobility solutions that are as unique as our client’s needs.

Working at National Seating & Mobility is an opportunity to build a meaningful career, while leaving a lasting impact on the lives of those we serve. Located in more than 40 states, we strive for diversity and offer an array of benefits including 401k, company paid Long Term Disability, and tuition reimbursement.

1. Develops and maintains working knowledge of current durable medical equipment and policies and procedures held by National Seating & Mobility as well as all applicable insurance guidelines regarding eligibility for coverage and reimbursement.

2. Ensures compliance with National Seating & Mobility policies and procedures.

3. Manages transaction cycle time (TCT) from Coding and Pricing Complete to Documentation Complete, making certain that all necessary steps are taken in the appropriate order ensuring timeliness of process and quality of funding approval.

4. Supports the Funding Specialist position due to PTO, LOA, FMLA, open positions and any other need as identified by the Division Funding Director, Funding Manager or Funding Supervisor.

a. Communicates regularly and professionally with Referral sources, Physicians, Therapists, RTSs, and Clients to secure documentation as required by payer.

b. Meets quality documentation follow-up attempt frequency and quality per policy following the escalation process. When necessary, attempts are to be made more often and as directed by the Funding Manager or Funding Supervisor.

c. Requests, gathers, and reviews documentation for funding package and deferrals, including but not limited to: proper prescriptions, Letters of Medical Necessity (LMN), RTS evaluation information, price lists, forms (AOB, ABN, rent or purchase letter).

d. Thorough review of all documentation received ensuring payer guidelines are met must be completed prior to satisfying the document in the work order. When documentation is not complete or accurate, immediate contact with the Referral source, Physician, Therapist, RTS, and/or Client to discuss and educate is required.

e. Gathers and verifies insurance coverage information and communicates benefits and coverage information to client.

f. Maintains communication with client throughout the process when applicable, including notifying them of and collecting financial responsibility or guiding them through the hardship process, where allowed.

g. Responsible for relationship management and funding related communication with Referral sources, Physicians, Therapists, RTSs, Clients and other internal and external customers.

h. Follows the document collection Escalation Policy and communicates with all necessary parties per the guidelines.

i. Communicates changes and escalations in the process and collects needed information from branch personnel, Referral sources, Physicians, Therapists, RTSs, and Clients.

j. Coordinates with other funding areas and…