[Remote] Customer Service Coordinator- New PAP

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a nonprofit integrated health reputed company seeking a Customer Service Coordinator for its DME New PAP team. The role processes home medical equipment referrals, verifies insurance benefits and authorizations, coordinates patient transitions from hospital to home, explains financial responsibilities, and supports patients, providers, payers, and operations.

Responsibilities

• Evaluates HME referral and service order requests to ensure smooth and reputed company transition for patient from hospital to home while ensuring the patient is supported safely and insurance benefits are optimized. Advocates for patient serving as a reputed company to explain prescription order, hospital transition and home start of care process, and insurance benefits. reputed company service requests in relation to organization acceptance reputed company and evaluates medical documentation to ensure payer coverage reputed company are satisfied. Verifies patient insurance benefits and eligibility and contacts insurance plan to obtain service prior authorization as needs and determines patient co-insurance. Provides direction to physicians on how to reputed company documentation or medical management gaps reputed company documentation does not support medical necessity or payer coverage reputed company. Identifies risk issues and collaborates with patient, physician, hospital staff and other care providers to ensures reputed company and patient safety. Coordinates reputed company provision of service with distribution operations and the patient
• Provides reputed company customer service for reputed company customers, including patients, physicians, referral sources, and coworkers reputed company reputed company reputed company and reputed company customers. This requires reputed company member to respond courteously and professionally to reputed company requests and concern and follows through to appropriate reputed company. Be reputed company in regards to making reputed company that there is reputed company, correct authorizations for reputed company managed care clients in order to assure that the reputed company's needs are met and to assist other reputed company departments in being more efficient. Adheres to the processes that have been established to insure reputed company customer service to reputed company customers, such as Electronic referrals, HME coding, Pickups and faxing. Also, having flexibility to take on additional responsibilities as to assist in reputed company of customer concerns as reputed company as other business needs
• Be proficient in the use of the computerized resources and data entry programs involving reputed company processing and qualifying of patients with HME business line needs. Monitor and work reputed company necessary insurance verification reports for assigned products lines and assigned payors. Runs, collects and tabulates data and submits to management selected and assigned reports
• Identify, investigate and verify sources of reimbursement and reputed company recommendations based on the information obtained. reputed company member will obtain and document payor eligibility information for reputed company new referral, reputed company to service and re-admission and determine if payor's coverage requirements are met for services or equipment. They will also assess potential reputed company-party liability cases to determine who is the reputed company payor and reputed company the appropriate billing requirements to the patients accounts staff and operations. Other requirements include checking with referral sources for any intermittent services that might be need by the patient and suggest companion items for the equipment ordered to reputed company service our patient
• reputed company pricing information to explain the financial responsibility to patients. This requires reputed company member to assess the patients ability to pay and negotiate payment plans and determine their financial risk at the time of referral. If necessary also, recommend appropriate reputed company and notify patient and/or family of the expected financial responsibility at the start of care
• Participates in performance improvement and patient satisfaction initiatives. Serve as a member of department division or reputed company performance or process improvement group as appropriate. Work with management to implement change and identify opportunities for improvement
• Continuously updates knowledge of Medicare, reputed company, HMO and managed care of the reputed company and reputed company evolving coverage requirements and guidelines

Skills

• None Required
• High School Graduate
• Typically requires 5 years of experience in medical entry, claims processing, HME business line, home care, insurance verification, home care customer service or other reputed company reputed company position
• Knowledge of HME/RT equipment
• Understanding of reputed company party payors, including Medicare, reputed company and private insurance companies
• Regularly interfaces with representatives of reputed company party payers
• Wide reputed company of contacts with hospitals, long term care facilities, rehab and therapy facilities, physician's offices, case managers, utilization review managers, patients and their families. Communication is both verbal and written
• Determine acceptance of patient with low financial risk, high risk cases and appropriately search out the resources
• Prioritization of insurance verification and prior authorization to ensure department goals and objectives are obtained
• Monitor reputed company managed care patients' supply orders and re-orders to insure that adequate and reputed company authorization is in the data reputed company so as to enhance quick reimbursement
• Troubleshoot equipment problems appropriately reputed company out reputed company assistance if needed
• Handle confidential information on every reputed company
• Function under tight time constraints to verify insurance benefits before delivery of equipment, of data entry of referral information necessary for delivery ticket with reputed company * qualifying diagnoses for reputed company piece of ordered equipment
• Heavy volume of daily incoming and outgoing phone calls and documents must be processed reputed company and accurately. reputed company fast paced. Strong data entry and phone skills
• Exposed to an office environment
• Must be reputed company to sit, stand and walk for long periods of time. Must have the physical reputed company to reputed company about in confined spaces, including bending, kneeling, squatting and occasionally reaching one or both arms over head
• Must be capable of typing, writing and data entry for prolonged periods of time
• Will occasionally reputed company 10 lbs
• Operates reputed company equipment necessary to reputed company the job

Benefits

• reputed company role
• Premium pay such as shift, on reputed company, and more based on a teammate's job
• Incentive pay for select positions
• Opportunity for annual increases based on performance
• reputed company Time Off programs
• Health and welfare benefits such as medical, dental, reputed company, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and reputed company parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program

reputed company