CMN/PAR LPN - Team Lead

Job Description

Job Description

CMN/PAR LPN – Team Lead

Job Summary

We are looking for an experienced LPN with DME experience to lead our CMN/PAR team. This person will be responsible for overseeing the day-to-day CMN and PAR process and making sure orders are properly documented and handled in a timely manner.

The person in this position will work closely with Intake, Billing, Reimbursement, physicians, insurance companies, and other departments to make sure we have the documentation needed to process and get paid for DME orders.

The CMN/PAR LPN will be responsible for spearheading the CMN/PAR team, keeping the department organized, following up on outstanding items, and helping the team stay on top of its workload.

DME experience and Brightree experience are required for this position.

Responsibilities

• Lead the day-to-day activities of the CMN/PAR team.

• Keep track of outstanding CMNs, PARs, physician orders, and other required documentation.

• Assign and follow up on work within the department.

• Review DME orders and clinical documentation for completeness.

• Review CMNs and other physician documentation.

• Prepare and submit PARs and prior authorization requests.

• Follow up with physician offices for missing information, signatures, and documentation.

• Follow up with insurance companies regarding pending authorizations and documentation.

• Review patient information to make sure the requested equipment is supported by the medical documentation.

• Track approvals, denials, and requests for additional information.

• Help the team resolve problems with documentation and authorizations.

• Review the team's work for accuracy and completeness.

• Train and assist CMN/PAR staff when needed.

• Make sure the team is following company procedures and payer requirements.

• Work with Intake, Billing, Reimbursement, and Operations when issues come up.

• Keep management informed of outstanding issues, delays, and problems that need attention.

• Help prepare patient records for audits.

• Make sure all appropriate information is documented in Brightree.

• Maintain patient confidentiality and follow HIPAA requirements.

• Perform other duties as assigned by management.

Brightree Experience

Brightree experience is required.

The candidate must have actual working experience using Brightree in a DME environment.

Experience should include:

• Entering and reviewing patient information.

• Managing DME orders.

• Reviewing order status.

• Tracking CMNs and PARs.

• Tracking authorizations.

• Reviewing documentation.

• Updating patient and order information.

• Documenting notes and follow-up.

• Keeping track of outstanding items.

Applicants without DME Brightree experience will not be considered for this position.

Required Qualifications

• Current, unrestricted LPN license.

• At least 2 years of DME/DMEPOS experience.

• Previous Brightree experience in a DME company is required.

• Experience with CMNs and PARs.

• Experience with prior authorizations.

• Knowledge of DME documentation and medical necessity requirements.

• Experience working with physician offices and insurance companies.

• Medicare and other insurance experience preferred.

• Good computer skills.

• Strong organizational skills.

• Good follow-up skills.

• Strong attention to detail.

• Good communication skills.

• Ability to manage multiple orders and deadlines.

• Ability to work independently and take ownership of assigned responsibilities.

• Previous experience leading or training other employees is preferred.

Team Leadership

This person will be expected to take ownership of the CMN/PAR department and keep the team moving.

The Team Lead should be able to:

• Keep the team organized.

• Make sure work is being completed on time.

• Follow up when something is outstanding.

• Help employees when they have questions or problems.

• Identify issues before they become bigger problems.

• Make sure the team is properly documenting its work.

• Communicate with management when additional support is needed.

• Help train new CMN/PAR employees.

• Maintain a professional and productive work environment.

What We Are Looking For

We are looking for someone who already understands the DME business and can step into the position without needing to learn the basics of DME.

The right person will be comfortable working in Brightree, understands CMNs and PARs, knows how to work with physicians and insurance companies, and is willing to take responsibility for keeping the CMN/PAR department organized and on track.

Work Requirements

• Office-based position.

• Must be able to work at a computer for extended periods.

• Must be able to communicate by phone and email throughout the day.

• Must be able to handle multiple priorities and deadlines.

• Must be dependable, organized, and able to work as part of a team.

Disclaimer

This job description is intended to describe the general responsibilities of the position. Duties may change based on the needs of the company and department.