Patient Services Representative
3 months ago
Job Title: Patient Services Representative
Job Code: PSPC1
Reports To: Patient Care Team Lead
FLSA Status: Non-Exempt
Department: Patient Care
Prepared Date:05-07-24
SUMMARY: The Patient Services Representative is responsible for all incoming and outgoing calls in a call center environment on a call queue, follow-ups with patients to promote product satisfaction and encourage continued use of our products. This includes telephone, text, mail / email and processing of internet leads.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
• Communicate routinely with patients to ensure product satisfaction and compliance with prescribed medical devices and supplies. Track and review due dates, contact patients per department procedures, and process orders for ongoing supplies, and replacement medical devices.
• Ensure timely order delivery, patient fittings, and pick up of rental equipment by coordinating with multiple departments including Distribution, Field Sales staff, and Patient Technical services.
• Communicate with medical insurance organizations to obtain authorizations, renewal, and the purchase of rental equipment.
• Answer incoming calls to resolve patient concerns, educate on the use of medical devices, capture incident reports, discuss medical insurance coverage and benefit information, authorization process, and patient payment options.
• Receive, process, and prepare written summaries of patient, physician, or insurance correspondence per departmental timelines and procedures and prepare benefit analysis reports from patient use of prescribed medical devices.
• Verify that all required patient medical documentation complies with company guidelines and payor standards of medical necessity for compliance, authorizations, and reimbursement of services.
• Prioritize multiple tasks, complete projects on time, and perform other job functions with a high level of proficiency as needed.
COMPETENCY:
To perform the job successfully, an individual should demonstrate the following competencies:
• Leadership Responsibilities: The Patient Care Coordinator typically trains and guides other non-exempt staff, as needed, but will not have any direct reports.
• Decision Making, Judgment and Problem Solving: To act on broad knowledge of advanced concepts, principles, procedures & specialized job tasks to achieve solutions.
• Job Knowledge: To effectively act on specialized knowledge of Company practices, policies, procedures and job tasks to complete a wide variety of complex or non-routine assignments.
• Project Management, Planning & Organization: To effectively plan and organize responsibilities to complete assignments within required parameters and pre-established time-management standards.
• Communication and Ethics: To appropriately and ethically represent the company and initiate actions and/or communications which will best serve the interests of VQ OrthoCare
EDUCATION/EXPERIENCE:
• High School Diploma/GED
QUALIFICATIONS:
• Experience in a call center environment or medical office setting with a high call volume.
• Understanding of medical terminology and medical documentation review.
• Ability to add, subtract, multiply, and divide.
• Proficient in software such as Word, Excel.
PREFERRED QUALIFICATIONS:
• Knowledge of insurance company guidelines for contracted payors, group health, managed care, workers’ compensation, personal injury and/or governmental payor patient referrals consistent with corporate policy and procedures
• Experience with durable medical equipment, troubleshooting, product knowledge
PHYSICAL AND MENTAL DEMANDS:
• Typically interacts with staff, peers, senior management and external customers.
• Ability to handle moderate to high stress.
• Regularly required to sit, stand, move about, stoop, bend, and reach.
• Regularly must see and read computer displays and reports, PDA displays & cell phone displays.
• Must regularly type and or enter data using computer keyboards.
CERTIFICATES AND LICENSES:
No special certificates, licenses or registrations are required.
SUPERVISORY RESPONSIBILITIES:
The job has no supervisory responsibilities.
WORK ENVIRONMENT:
Reasonable accommodations may be provided in order to allow qualified individuals with disabilities to perform the essential duties and tasks. The work environment varies between that of a typical office setting with controlled temperature and humidity and a typical automobile interior, traffic and noise associated with commuting. Ambient noise levels are consistent and generally low.
*VQ Orthocare is and Equal Opportunity Employer: All Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
**VQ Orthocare is a participating E-Verify employer
Company DescriptionVQ Orthocare is a DME manufacturer and retailer recently celebrating our 25th yearCompany DescriptionVQ Orthocare is a DME manufacturer and retailer recently celebrating our 25th yearWe have other current jobs related to this field that you can find below
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