
Wound Care Specialist
11 hours ago
The Role:
We are seeking a dedicated and skilled Wound Care Specialist to join our healthcare team. In this position, you will be responsible for managing patient wound care records, verifying insurance eligibility, and coordinating the supply of essential medical materials.
This is a remote opportunity that offers flexibility working from home.
Responsibilities Include:- Progressing records for wound care intake management
- Generating reports and documents for patients with wounds at review time
- Communicating with the payer team to determine insurance eligibility and assess which wounds are eligible for supplies under Medicare medical necessity guidelines
- Storing and organizing records of clinical details, dispensing orders, and documents
- Entering patient, wound, and dressing data into wound orders and spreadsheets
- Adding product specifics to spreadsheets and supporting product verification steps to prepare orders including sizes, quantities, and preferred brands
- Validating medical necessity for existing orders and documenting changes accurately
- Communicating via email and phone with staff regarding clinical questions or timeline on order signatures required for delivery date
- Collaborating with the clinical review team in other service lines may be required
- Tracking communication and findings within the company system
- Providing support for tracking systems, IT, and spreadsheet tools for chart reviews and order preparation
- Supporting streamlining communication and workflow with available resources
- Maintaining a working knowledge and tracking of product billing and reimbursement data
- Researching cost-effective and comparable product resources
- At least 2 years of clinical wound care experience preferred
- Diploma/ Degree in Nursing, Medicine, or related field
- Excellent English communication skills, both verbal and written
- Ability to work in a fast-paced environment
- Strong critical thinking and customer service skills
- Knowledge of eligibility, Medicare, and product guidelines for education sessions i.e., Noridian LCD
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