Qualification Specialist

Job Description
Norco is currently seeking an individual to fill our Qualification Specialist Position on the Complex Mobility Team. The Qualification Specialist ensures that medical documentation is accurate and gathered in an efficient and timely manner for all orders. Other responsibilities include, but are not limited to:
Have knowledge of the documentation requirements for the payers and product categories for which Norco provides services
Have knowledge of insurance company policy manuals, fee schedules, and contracts
Perform Insurance Verification
Gather medical documentation required to meet specific insurance company's guidelines
Submit and obtain insurance prior authorizations via fax, online portal entry, mail, etc for equipment prior to delivery whenever possible
Review documentation to assure pay coverage criteria is met when a prior authorization cannot be obtained from the insurance company
Follow up with therapists and physicians when DWOs, DPDs, chart notes, and LMNs are not received per Norco protocol
Stay abreast of industry updates and Medicare changes
Perform other tasks as assigned or necessary