DME Customer Order Specialist Supervisor

The Kestra team has over 400 years of experience in the external and internal cardiac medical device markets. The company was founded in 2014 by industry leaders inspired by the opportunity to unite modern wearable technologies with proven device therapies. Kestra’s solutions combine high quality and technical performance with a wearable design that provides the greatest regard for patient comfort and dignity. Innovating versatile new ways to deliver care, Kestra is helping patients and their care teams harmoniously monitor, manage, and protect life.

The Durable Medical Equipment (DME) Customer Order Specialist Supervisor is responsible for supervising the day-to-day operations for the Order Processing Team by supporting the order processing needs of customers, patients, and field sales personnel via fax, phone, email, and chatter. A primary focus in supervising the Customer Order Specialists (COSs), is ensuring customer service is at the forefront of everything they do, whilst ensuring strict standards and the timeframes as promised to the customer are achieved. You will be the escalated point of contact for any issues, so you must be happy with being a keen problem solver and trainer. As a team supervisor, you will be responsible for driving a culture of inclusion and engagement through regular team meetings and 1:1s and team building activities.

This role regularly communicates with field sales personnel, patients, health care providers, health Insurance (payor) representatives and referral sources as it relates to competently and efficiently requesting and obtaining payor prior authorizations on behalf of patients in a friendly, caring, and professional manner. Frequently, this position discusses insurance benefits, out-of-pocket costs, deductibles, and payment methods with patients. This role helps train Customer Order Specialists in these duties.

Requirements

ESSENTIAL DUTIES:

  • Supervise regional COS team(s) as assigned by Manager, including scheduling work shifts to effectively cover the needs of Kestra customers
  • Participate in hiring, training, and coaching
  • Conduct performance evaluations of COSs
  • Perform COS duties as needed
  • Ensure accurate intake and processing of orders
  • Serve as escalation contact for regional order-related issues
  • Facilitate the entirety of the order process to ensure efficiency and effectiveness
  • Help troubleshoot order processing concerns
  • Make sure the teams KPI’s are achieved
  • Listen to COS calls to patients and payers
  • Attend and participate in Order Processing Leadership meetings as needed
  • Coordinate with sales representatives, physician’s office, and applicable internal/external personnel regarding medical records and information needed to obtain pre-authorization and benefits upon intake of new patient referrals. Confirm medical records meet medical necessity based on applicable insurance guidelines. Promptly follow-up on patient referrals, physician prescriptions and/or physician work orders
  • Verify eligibility and benefits of patient health insurance specific to Durable Medical Equipment (DME) by contacting insurance companies by phone, accessing insurance website portals, and utilizing Kestra’s medical billing software. Responsible for verification of active coverage, deductibles, accumulations, coinsurance, and pre-authorization requirements
  • Initiate, track, and complete pre-authorizations requests, including notifying applicable parties of the determination. Assist with appeals for Prior Authorization denials
  • Upon authorization, place orders for Durable Medical Equipment, notify, and dispatch patient product fitters
  • Perform data entry into medical billing software and other software (Salesforce) including patient demographics, prescribing physician’s information, insurance payor information, HCPCS procedure codes, ICD-10 diagnosis codes, etc.
  • Collaborate with the Billing Team as necessary and as directed by the Order Processing Manager to help facilitate the submission of claims to payers
  • Regularly communicate with patients to discuss their insurance benefits, out-of-pocket costs, and product payment arrangements
  • Escalate issues within insurance carriers when not able to obtain reasonable information
  • Answer incoming phone calls to office and route messages accordingly
  • Routinely export/import data from one software to another software
  • Create forms through auto-populating data into custom fields
  • Accurately complete forms/applications and send out to applicable destination
  • Be aware of and adapt to changes in medical regulations and processes
  • Participate in on-call and off hours coverage. Hours on-call and worked may include evenings, weekends, and holidays
  • Adhere to Pledge of Confidentiality
    • Information regarding a patient of this company shall not be released to any source outside of this company without the signed permission of the patient. Furthermore, information will only be released internally on a need-to-know basis. All Team Members will not discuss patient cases outside the office or with anyone not employed by this company unless they are directly involved with the patient’s case.

COMPETENCIES:

  • Passion: Contagious excitement about the company – sense of urgency. Commitment to continuous improvement
  • Integrity: Commitment, accountability, and dedication to the highest ethical standards
  • Collaboration/Teamwork: Inclusion of Team Member regardless of geography, position, and productor service
  • Action/Results: High energy, decisive planning, timely execution
  • Innovation: Generation of new ideas from original thinking
  • Customer Focus: Exceed customer expectations, quality of products, services, and experience always present of mind
  • Emotional Intelligence: Recognizes, understands, manages one’s own emotions and is able to influence others. A critical skill for pressure situations
  • Accuracy: Perform detailed notetaking on pertinent information e.g., reference #s, dates, spelling of names, ID#s, phone #s, email addresses
  • Empathy: Exercise exceptional patience when communicating with patients and customers

QUALIFICATIONS:

Education/Experience Required:

  • High School Diploma or GED
  • Two (2) or more years managing or supervising an order processing team
  • Three (3) or more years processing DME orders/prescriptions
  • Three (3) or more years of experience with Insurance verifications, which include gathering prior authorization required documents and submitting/following-up prior authorizations requests to payors
  • Three (3) or more years of direct experience using payor portals and having to call payers to conduct insurance verification
  • Consistently detail-oriented and thorough
  • Advanced written and verbal communication skills, to include excellent grammar
  • Advanced reading and comprehension abilities
  • Advanced analytical skills and detail-oriented
  • Advanced multi-tasking skills
  • Advanced organizational and prioritization skills, with strong ability to meet strict deadlines
  • Proficient typing skills
  • Proficient with Microsoft Word, Microsoft Outlook, Adobe Acrobat, general internet research, and beginner knowledge of Microsoft Excel
  • Familiarity with PDF editing

Preferred:

  • Experience with HCPCS procedure codes and ICD-10 codes
  • Experience processing Orders for Wearable Cardioverter Defibrillators or other Cardiac DME devices

WORK ENVIRONMENT:

  • Remote, yet fast paced work environment
  • Noise level typical of an open office environment
  • Kestra manufactures and provides life-saving products regulated by the Federal Food and Drug Administration and under contract with Medicare. Kestra maintains a drug free workplace and testing is a condition of employment

PHYISCAL DEMANDS:

  • Frequent repetitive motions that may include wrists, hands and/or fingers, such as keyboard and mouse usage
  • Frequent stationary position, often sitting for prolonged periods of time
  • Occasional bending and stooping
  • Occasional lifting up to 20 pounds

TRAVEL:

  • Occasional travel, less than 10%

OTHER DUTIES:

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

Benefits

Kestra offers a very competitive benefit package including Medical, Dental, 401K with Match, etc.

Pay equity is an important part of Kestra’s Culture. Our compensation ranges are guided by national and local salary surveys and take into consideration experience level and internal equity. Each role is benchmarked based on the job description provided. If your qualifications and/or experience level are outside of the posted position, we encourage you to apply as we are growing fast and roles that are coming soon may not be posted.

Salary: $70,500-$85,000 Depending on experience.

Kestra Medical Technologies is an equal opportunity employer. Kestra Medical Technologies does not discriminate on the basis of race, color, religion, national origin, veteran status, disability, age, sexual orientation, gender identity and/or expression, marital status, or any other characteristic protected by law.

We are unable to sponsor or take over sponsorship of employment visas at this time. Applicants must be eligible to work for any employer in the U.S.