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Founded in 1991, The SCOOTER Store is headquartered in New Braunfels, Texas and has locations and a network of service specialists across America. The SCOOTER Store has grown from a vision into a highly successful national enterprise with over 2,200 employee-owners.
The SCOOTER Store maintains strict compliance with Medicare regulations and works through the Power Mobility Coalition to ensure the availability of additional consumer safeguards and industry standards such as ongoing customer service and product maintenance. The SCOOTER Store is accredited by the Accreditation Commission for Health Care, Inc. (ACHC).
Summary:
This professional clinician will provide detailed and comprehensive written summaries to support the Corporate Medicare Appeals Process. Ability to render critical clinical assessment, analysis and case support in written form with a broad medical knowledge base is essential. The employee presents evidentiary testimony in formal hearings, and acts as a professional witness in various settings before Administrative Law Judges (ALJs). The employee must be astute and articulate in describing multiple clinical conditions, medications, and co-morbidities as they relate to medical necessity for power wheelchair and Power Operated Vehicles. The employee must be able to work in a multi task setting and be able to interact effectively with various health care professionals as well as attorneys, hearing officers, Judges, and Medicare physicians and nurses. The employee must be familiar and stay current with the DMERC/ Medicare reimbursement process.
Essential Duties and Responsibilities:
• Independently analyze and interpret clinical descriptions and documents that are in the appeals process and be able to draw relevant inferences and interpret evidence for successful Medicare reimbursement
• Write complex clinical summaries and other documents in a prescribed format
• Supervise and train other clinical nurses and act as coordinator of workflow and processes
• Interface in a positive verbal manner with a variety of interdisciplinary professionals
• Possess a clear and detailed understanding of Medicare Compliance as it relates to Power wheelchairs and POVs
• Provide educational opportunities for health care professionals, attorneys, judges, interdepartmental peers, and other principles within The SCOOTER Store
• Ability to communicate complex medical issues and concepts to management, attorneys and other judicial personnel
• Ability to define problems, collect data, establish facts and draw valid conclusion
• Ability to interpret an extensive variety of technical information and deal with abstract and concrete variables
• Ability to work with specific computer software (Outlook, Word, Excel, PowerPoint, etc.)
• Familiarity with special terminology such as medical or legal terms
• Present a clinical argument accurately & convincingly for establishing medical necessity in front of an Administrative Law Judge
Education and/or Experience:
Current Texas Nursing License, LVN/RN with 1- 3 years of clinical nursing experience.
Certificates, Licenses, Registrations:
Current Texas Nursing License
Other Knowledge, Skills and Abilities:
• Working knowledge of Product line.
• Working knowledge of HCPC and ICD 9 codes
In return for your experience, The SCOOTER Store offers a competitive salary and a generous benefits package.
The SCOOTER Store World Headquarters, Distribution Centers, and Stores are tobacco-free facilities.
The SCOOTER Store is an Equal Opportunity Employer.
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