[Hiring] Senior DME Referral Care Coordinator @Paradigm

Role Description

Paradigm is seeking a Senior DME Referral Care Coordinator to coordinate the timely, accurate, and compliant delivery of durable medical equipment for injured workers and patients with complex needs. In this fully remote role, you will manage the DME referral process from intake and authorization through delivery and billing support, working closely with vendors, providers, payors, and internal teams to resolve barriers and keep services on track.

As a subject matter expert, you will handle complex or escalated cases requiring advanced problem-solving and coordination while serving as a resource for team members. This role also supports onboarding, training, and process improvements that enhance service quality, improve turnaround times, and create an exceptional customer experience.

This is a full-time, fully remote position. Work hours are Monday through Friday, either 9:30 a.m.–6:00 p.m. EST or 12 p.m.–8:30 p.m. EST.

Responsibilities

• Receive, review, and process Complex DME referrals from internal and external referral sources, ensuring accuracy and completeness prior to fulfillment.
• Coordinate with payors to obtain required authorizations prior to DME delivery.
• Work closely with DME vendors, providers, injured workers/patients, and referral sources to ensure appropriate equipment is delivered within required timeframes.
• Provide proactive status updates and delivery confirmations to all stakeholders.
• Manage complex, high risk, or escalated DME cases requiring advanced problem solving and coordination.
• Ensure accurate pricing and documentation are provided to Billing to support timely and correct invoicing.
• Maintain complete and compliant documentation, including prescriptions, clinical notes, authorizations, and invoices, in accordance with company policy and regulatory requirements.
• Assist with reconciliation of unmatched claims or billing discrepancies as needed.
• Ensure compliance with payer guidelines, regulatory requirements, and internal policies related to DME and Protected Health Information (PHI).
• Demonstrate a customer-first mindset by developing a broad and deep understanding of Paradigm organization, products, operations, and customers.
• Provide exceptional customer service, addressing questions, concerns, and complaints in a timely and professional manner.
• Maintain reliable and predictable attendance during scheduled work hours.
• Follow up with injured workers/patients and referral sources to ensure satisfaction and resolve service issues.
• Serve as a resource and mentor to DME Coordinators and Intake staff, providing guidance on workflows, systems, and complex cases.
• Assist leadership with onboarding and training of new team members.
• Support process improvement initiatives, documentation updates, and special projects related to DME operations.
• Identify opportunities to improve turnaround times, vendor performance, and service quality.
• Utilize AI tools to support day-to-day tasks, improve efficiency, and enhance output quality.
• Comply with Paradigm Information Security requirements and policies.

Qualifications

• High school diploma or equivalent required; associate degree or higher preferred.
• Minimum 3–5 years of experience in DME coordination, referral management, or related healthcare operations.
• Strong knowledge of Durable Medical Equipment processes, authorizations, and vendor coordination.
• Strong knowledge of medical terminology, healthcare documentation, and complex injuries.
• Proficiency with healthcare systems, referral platforms, and Microsoft Office applications.
• Excellent organizational, prioritization, and multi-tasking skills.
• Strong written and verbal communication skills with a customer service focus.
• Workers’ Compensation or Care at Home experience.
• Prior experience handling escalated or complex DME cases.
• Experience mentoring or supporting junior staff.
• Familiarity with DME billing workflows and payer requirements.
• Attention to detail and accuracy.
• Customer Centric Mindset.
• Problem solving and critical thinking.
• Collaboration and teamwork.
• Confidentiality and professionalism.

Benefits

• Health and wellness: PPO, HDHP, and HMO health insurance options with Cigna and Kaiser (CA employees only).
• Financial incentives: competitive salaries, 401(k) matching contributions, employer-paid life and disability insurance, flexible spending and commuter accounts, and employer-matched HSA contributions.
• Vacation: paid time off and personal holiday programs for work-life balance.
• Volunteer time: one paid day per calendar year for community engagement.
• Learning and development: support for continual learning through the Learning Excellence at Paradigm (LEAP) program.