Careers

Join our positive, friendly & team-oriented work environment.

One Health Direct (OHD) is a HIPPA and Medicare compliant medical equipment company offering diabetic and durable medical equipment products and physician referral services with locations in the US and Puerto Rico, and Philippines.

One Health Direct provides everything needed to help patients receive innovative treatment options without putting the onus on the physician and their staff to ensure everything is in order and all requirements are met. From eligibility through product fulfillment, OHD provides the tools, and personal assistance necessary to streamline the process and maximize efficiency. The OHD system greatly reduces the burden and workload on   physicians and staff.

We are seeking an experienced insurance verification and eligibility specialist to join our team in Birmingham.  Current working knowledge of insurance and eligibility experience in the DME, HME, hospital or physician office environments is a must.  The ability to work and communicate with a professional, calm, patient demeanor is highly required in this role.  A person with a good working knowledge of medical equipment products, such as the CGM, who can bring awareness of the product(s) to insurance companies, highly desirable.

We are dedicated to and encourage a strong work life balance for personal and professional success.  We are looking for a positive, motivated and self-reliant individual to join our team.

Duties/Responsibilities:

• Research and follow up on authorization denials
• Troubleshoots and seeks solutions to problems related to questions and concerns over health insurance coverage and explanation of benefits, orders and sales efforts
• May be required to explain Continuous Glucose Monitoring System (CGMS) insurance benefits coverage to payers, discuss how it works, and describe the functions and supplies that go with CGMS
• Working on projects within the wider group and cross functions
• Verifies patient specific benefits and precisely documents specifics for various payer plans including patient coverage, cost share, and access/provider options according to Program specific SOPs
• Completes quality review of work as part of finalizing product
• Reports any reimbursement trends/delays to supervisor
• Work requires focus, flexibility, and the ability to adapt to changing work situations
• Serves as an insurance and coverage resource as needed
• Think in an anticipatory way – be one step ahead of the process
• Must be able to handle multiple tasks and organize multiple files simultaneously
• Must be able to handle a high volume of orders
• Must be able to manage timely follow up and remain diligent to problem solving verification and eligibility issues with the ability to think in an anticipatory way.
• Ability to comprehend and interpret documents and data
  
  

Required Skills/Abilities:

• Required – 3-5 plus years of proven insurance verification and eligibility experience in a DME, HME, Hospital or Physician’s office
• Minimum of 3+ years of current knowledge of Insurance benefits which includes deductibles, Co-Insurance, out of pocket, exclusions, and Prior Authorization requirements
• Required working knowledge of insurance terms and coverage

• Must have excellent communications skills with the ability to communicate clearly in detail, remain calm and exercise patience.
• Excellent organizational skills
• Excellent trouble shooting, problem-solving and critical thinking ability with proven experience
• Current working knowledge and understanding of insurance verification and eligibility cross over
• Navigate between multiple and concurrent computer applications.
• Must have a good computer proficiency and be comfortable with computer applications such as Microsoft office suite of products.
• Must have experience with
  
  • Insurance provider portals
  • Availity or similar product
  • P-verify or similar product
  • CGS and Noridian Medicare products or similar
  • Brightree experience highly desirable
• Must possess the qualities of a disciplined, self-managing individual with the ability to seek out work areas
• Open & receptive to coaching.
  
  

We encourage you to apply!

Insurance verification and/or eligibility specialist with a minimum of 3 years of experience working durable medical equipment environment, home medical equipment environment verification and eligibility for patients in any environment including hospitals or doctor offices.