MIR专员
MIR Specialist
职位描述：
与资金经理、资金主管、分行经理、康复技术供应商（RTS）及其他办公室支持人员协调，确保所有操作流程按照公司政策并在预期时间内完成。负责纠正和重新处理任何无法计费或因信息缺失或错误导致索赔被拒的订单。这包括编码与定价、收集与资金包相关的相关信息和文件，确保所有文件齐全，提交给资金来源并收集付款人决定，包括授权、拒付和延期。
公司简介：
在国家座椅与移动公司，无论哪个层级工作，都能直接对客户的生活产生影响，让他们获得自主性和独立性。我们的团队由充满热情的个人组成，致力于为每位客户提供最好的护理。我们通过利用技术，创造符合客户需求的独特移动解决方案。
在国家座椅与移动公司工作是一个建立有意义职业生涯的机会，同时对我们服务的人的生活留下持久的影响。我们在超过40个州设有办事处，致力于多元化，并提供多种福利，包括401k、公司支付的长期残疾保险和学费报销。
职责与主要职能：
1. 负责解决、纠正和重新处理任何无法计费或因信息缺失或错误导致索赔被拒的订单。
2. 确保所有必要编码、修饰符和价格的准确性和完成更新。
3. 核实客户福利和覆盖范围，并向客户传达福利信息。
4. 收集并审查付款人的文件，包括但不限于：正确的处方、医疗必要性证明（LMN）、RTS评估信息、价格清单、表格（AOB、ABN、租赁或购买信）。
5. 定期与医生、治疗师、RTS和客户沟通，以获取付款人要求的文件。
6. 传达流程中的变更和升级，并从分行员工、转介来源、医生、治疗师、RTS和客户处收集所需信息。
7. 调查并更新任何付款人的要求。
8. 在整个过程中与客户保持沟通，如适用。
查看英文原文
Statement of the Position:
Coordinates with the 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 correcting and reworking any order that is unable to be billed or has resulted in a claim denial due to missing or incorrect information. This can include Coding & Pricing, gathering information and documents pertinent to the funding package, ensuring that all documentation is in place, submission to the funding sources and collecting payer decisions including authorizations, denials, and deferrals.
Company Description:
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.
Duties and Responsibilities / Essential Functions:
1. Responsible for problem-solving, correcting, and reworking any order that is unable to be billed or has resulted in a claim denial due to missing or incorrect information.
2. Ensures the accuracy of and completes updates to all required coding, modifiers and pricing.
3. Verifies client benefits and coverage and communicates benefit information to client.
4. Gathers and reviews documentation for payer, including but not limited to: proper prescriptions,
Letters of Medical Necessity (LMN), RTS evaluation information, price lists, forms (AOB, ABN, rent or purchase letter).
5. Communicates regularly with Physicians, Therapists, RTSs, and Clients in an effort to secure documentation as required by payer.
6. Communicates changes and escalations in the process and collects needed information from branch personnel, Referral sources, Physicians, Therapists, RTSs, and Clients.
7. Investigates and updates any payer requirements.
8. Maintains communication with client throughout the process when applicable, including notifying them of financial responsibility.
9. Coordinates with branch staff to secure pick up and redelivery documentation as required.
10. When appropriate, discusses and secures approvals to write off or adjust balances.
11. Communicate with Billing and Collection team to ensure that timely filing deadlines are met and/or to resolve any clarification on MIRs.
12. Properly noting and closing MIRs with a complete and thorough response through the Funding Portal and Mobility Advisor.
13. Performs any related job duties assigned by the MIR Manager. Carries out all position expectations in a professional manner and with minimal supervision.
14. Responsible to complete all continuing education requirements to include assigned NSM University courses.
15. Must maintain regular and predictable attendance.
Work Environment:
This position primarily operates in a work from home environment. The work from home policy and requirements must be adhered to. Occasionally, this job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, printers, photocopiers, filing cabinets and fax machines.
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. While performing the duties of this job, the employee is regularly required to talk or hear. The employee is regularly required to sit; use hands repetitively to operate standard office equipment. The employee is frequently required to reach with hands and arms.
Required Education, Experience, & Competencies:
- Has minimum of 3 years of experience related to Durable Medical Equipment and/or Complex Rehab Technology required, preferred experience in all aspects of a Funding Specialist’s position including how to process both Repairs and Non-Repairs.
- Has extensive knowledge of the process and insurance guidelines to secure funding for Durable Medical Equipment and/or Complex Rehab Technology including comprehensive knowledge of insurance verification for DME.
- Proficient in Microsoft Excel, Word, and Outlook.
- Strong ability to problem solve, knowledge of NSM P&P and ability to interpret and follow payer guidelines and all Policies and Procedures.
Originally posted on Himalayas