DME Services Manager

Description

Founded in 1991, IBJI is the largest orthopedic group practice in Illinois. With more than 150 physicians in every orthopedic specialty, IBJI offers care for adults and children from some of the most accomplished and respected orthopedists in the country. Serving northern Illinois and northwest Indiana with over 100 locations, IBJI makes it easy to access care. Our headquarters is in Park Ridge, Illinois, a northwest suburb of Chicago.

Our clinical services include advanced MRI imaging, pain management, non-surgical and surgical treatment plans, rheumatology, physical therapy, occupational therapy, wellness, and sports and sports training. Ortho Access walk-in clinics provide same day care for orthopedic injuries. Comprehensive care offered all in one place enables physicians, therapists and staff to work closely together, so that patients and families achieve better outcomes. Collaborative care is also more efficient.

In many cases, IBJI services are substantially less expensive than those provided by large healthcare systems and emergency rooms.

The objective of the DME Services Manager is to provide support, general oversight and appropriate interventions relative to assigned DME Service Centers and DME Services Coordinators. He/She will also provide expertise related to clinical and documentation as it relates to all of IBJI DME. The Goal of the position is to ultimately provide support and guidance to the extent that it yields excellence in IBJI’s DME service line that is consistently tied to our 3 core values and Mission Statement.

The position is under the general direction of the Director of Purchasing.

• Directly oversees DME Services Coordinators (DME SC)
• Responsible for Financial Performance of DME Service Centers in conjunction with DME SC
• Responsible for assisting in Budget development with the Director of Purchasing
• Responsible for Professional Level Staffing Interview and Hiring. Final approval of professional staff positions and progression to Corporate activation is the responsibility of the Director of Purchasing
• Approval of DME SC PTO and CEU
• Approval of Capital Expenses related to assigned Service Centers that exceeds $250
• Works in collaboration with RCM to address any audits that are related to IBJI DME.
• Works in conjunction with Compliance, Coding, and Legal to ensure DME compliance:
  Develops Path Training as needed, Trains IBJI staff on Epic
• Responsible for overall coordination and processing of new patient DME orders including:
  
  Pre-verification of insurance benefits, obtaining an estimate of benefits and pre-certification of claims as required
• Translating and entering prescriptions into the company information system
• Obtaining authorizations and communicating out-of-pocket estimates to patients
• Ensure that all necessary documentation is obtained as it relates to payer requirements, standard operating procedures, and IBJI compliance program. Assists and helps coordinate with the DME Audit Process in conjunction with
• Maintain good communication with physicians and administration as it applies to DME products (new products/product availability) and all documentation needed to process patient insurance claims
• Monitor and analyze new item requests for necessity and profitability from physicians and patients
• Accurately maintain billing and coding according to Medicare regulations IBJI standards Coordinate with outside vendors to be sure we have the most up-to-date information for billing and coding of products
• Manage and track patient billing information; work in coordination with HIS billing/collections department to ensure timely billing and appeals process
• Ensure all physicians and staff are educated on…