Spanish DME Client Services Assistant

Review physician orders, medical records, and supporting documentation to determine eligibility and medical necessity for DME items.
Verify insurance benefits, coverage criteria, authorization requirements, and documentation standards.
Submit prior authorization requests to Medicare, Medicaid, commercial insurance plans, and managed care organizations.
Follow up with insurance companies, clinics, physicians, and case managers regarding pending authorizations and documentation requests.
Review LCDs and payer guidelines to determine coverage eligibility.
Receive and sort incoming faxes.
Create tasks or workflow assignments for follow-up when additional action is required after sorting the documents.
Experience with industry-standard platforms such as Brightree and Availity is preferred.