Job Duties:
- Enters referrals within allotted timeframe as established; meeting productivity and quality standards as established.
- Communicates with referral sources, physician, or associated staff to ensure documentation is routed to appropriate physician for signature/completion.
- Accurately enters referrals into appropriate system based on the type of referral obtained.
- Works with local branch leadership to ensure appropriate inventory/services are provided.
- Assists with other regional team functions, as necessary.
- For non-Medicaid patients communicates with patients their financial responsibility, collects payment and documents in patient record accordingly.
- Follows company philosophies and procedures to ensure appropriate shipping method utilized for delivery of service.
- Answers phone calls in a timely manner and assists caller.
- For non-Medicaid patients communicates with patients Responsible for reviewing medical records for non-sales assisted referrals to ensure compliance standards are met prior to a service being rendered.
- Must be an expert at payer guidelines and reading clinical documentation to determine qualification status and compliance for all equipment and services.
- Responsible for working with community referral sources to obtain compliant documentation in a timely manner to facilitate the referral process.
- Responsible for contacting patient when documentation received does not meet payer guidelines to provide updates and offer additional options to facilitate the referral process.
- Works with sales team to obtain necessary documentation to facilitate referral process as well as support referral source relationships.
- Must be able to navigate through multiple online EMR systems to obtain applicable documentation.
- Works with verification team to ensure all needs are met for both teams to provide accurate information to the patient and ensure payments.
Competency, Skills and Abilities:
- Ability to appropriately interact with patients, referral sources and staff.
- Decision Making
- Analytical and problem-solving skills with attention to detail
- Strong verbal and written communication
- Excellent customer service and telephone service skills
- Proficient computer skills and knowledge of Microsoft Office
- Ability to prioritize and manage multiple tasks
- Solid ability to learn new technologies and possess the technical aptitude required to understand flow of data through systems as well as system interaction
Minimum Job Qualifications:
- High School Diploma
- One (1) year work related in health care administrative, financial, or insurance customer services, claims, billing, call center or management regardless of industry is required.
- Exact job experience is considered any of the above tasks in a Medicare certified HME, IV or HH environment that routinely bills insurance.
