CMN REPRESENTATIVE
Position Summary
Our CMN Representative is responsible for monitoring Certificate of Medical Necessity (CMN) and prescription activity in a timely manner. Key responsibilities include the prompt submission of CMNs, consistent follow-up and tracking, staying current with coverage criteria changes, and providing timely responses to referral sources and internal staff.
Highlights & Benefits
- Paid Time Off (PTO)
- Memorial Childcare
- Mental Health Services
- Growth Opportunities
- Continuing Education
- Local and National Discounts
- Pet Insurance
- Medical, Dental, Vision
- Flexible Spending Account
- 401(k)
- Life Insurance and Voluntary Benefits
- Employee Assistance Program and Colleague Wellness
- Adoption Assistance
Required Skills
- Retrieve access and print Certificates of Medical Necessity (CMNs) from the billing software. Prepare and forward CMNs to attending physicians for timely completion and signature.
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Document and monitor both paper and electronic systems to ensure proper issuance of clinical orders and CMNs, avoiding duplication or oversight.
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Verify clinical orders against Medicare, Medicaid, and other third-party insurance billing requirements. Secure or issue additional documentation as needed to meet payer guidelines.
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Use “tickler” files and system-generated reports to track the timely return of clinical orders and CMNs. Reissue duplicates and follow up with physician offices via phone or in person, as necessary.
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Receive, sort, and distribute completed and approved CMNs. Accurately log and maintain customer data in the billing software system.
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Communicate with physician offices—via mail, phone, fax, or in person—to resolve incomplete or incorrect CMNs.
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Regularly review and monitor the unbilled CMN report to ensure all outstanding items are resolved within pre-approved timelines.
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Provide feedback and suggestions to the marketing team to improve CMN processes and enhance documentation workflows with physician offices.
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Perform other related duties as required or assigned.
Required Experience
Education:
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High school diploma or equivalent required.
Licensure/Certification/Registry:
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Must possess a valid Illinois driver’s license and meet the requirements of the MHS Fleet Safety Policy.
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Must have access to a personal vehicle with current proof of insurance.
Experience:
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A minimum of one year of medical experience is preferred.
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Working knowledge of medical equipment and medical terminology is highly desirable.
Other Knowledge/Skills/Abilities:
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Basic to intermediate computer skills, including proficiency in Microsoft Office (Word, Excel, and Outlook), are required.
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Must be thorough and detail-oriented, with strong decision-making, communication, and interpersonal skills.
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Ability to build positive relationships with physician office staff.
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Must be able to multitask effectively, work independently, and consistently achieve goals related to CMN receipt processing.