About this role
Min
USD $17.14/Hr.Max
USD $26.56/Hr.Overview
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.
Qualifications
Education:
High school diploma or equivalent required.
Licensure/Certification/Registry:
Must possess a valid Illinois driver’s license and meet the requirements of the MHS Fleet Safety Policy.
Must have access to a personal vehicle with current proof of insurance.
Experience:
A minimum of one year of medical experience is preferred.
Working knowledge of medical equipment and medical terminology is highly desirable.
Other Knowledge/Skills/Abilities:
Basic to intermediate computer skills, including proficiency in Microsoft Office (Word, Excel, and Outlook), are required.
Must be thorough and detail-oriented, with strong decision-making, communication, and interpersonal skills.
Ability to build positive relationships with physician office staff.
Must be able to multitask effectively, work independently, and consistently achieve goals related to CMN receipt processing.
Responsibilities
- 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.
Document and monitor both paper and electronic systems to ensure proper issuance of clinical orders and CMNs, avoiding duplication or oversight.
Verify clinical orders against Medicare, Medicaid, and other third-party insurance billing requirements. Secure or issue additional documentation as needed to meet payer guidelines.
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.
Receive, sort, and distribute completed and approved CMNs. Accurately log and maintain customer data in the billing software system.
Communicate with physician offices—via mail, phone, fax, or in person—to resolve incomplete or incorrect CMNs.
Regularly review and monitor the unbilled CMN report to ensure all outstanding items are resolved within pre-approved timelines.
Provide feedback and suggestions to the marketing team to improve CMN processes and enhance documentation workflows with physician offices.
Perform other related duties as required or assigned.
Other facts
About Memorial Health
Memorial Health is one of the leading healthcare organizations in Illinois—a responsibility we are proud to uphold. Founded in 1897 to meet the expanding needs of our communities, we have assembled an ever-growing team and vast resources.
Dedicated to unsurpassed excellence in care, education, and research, our community-based, not-for-profit corporation features a team of nearly 10,000 strong throughout eight state-of-the-art affiliates offering a broad array of vital services. Yet what matters equally is the size of our heart. Our ambitions. And our potential to do bigger and better things.
We’re achieving our goals by developing academic alliances with other respected institutions, including the BJC HealthCare Collaborative and the Southern Illinois University School of Medicine. By earning important credentials and accreditations. By making a real investment in employee development. And by building upon our reputation for excellence on the regional level, with the goal of realizing national prominence.
What you'll do
- The CMN Representative is responsible for monitoring and submitting Certificates of Medical Necessity (CMNs) and ensuring timely follow-up and tracking. They also communicate with physician offices to resolve issues related to CMNs.
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