Customer Service Specialist

2 months ago

Boston, United States AdaptHealth corp. Full time

Customer Service Specialist Customer Service Specialists are responsible for learning and understanding the entire front-end process to ensure successful service for our patients. The Customer Service Specialists work in a fast-paced environment answering inbound calls and making outbound calls. They are responsible for obtaining, analyzing, and verifying the accuracy of information received from referrals, creating orders, and scheduling the patient to receive equipment as ordered by their doctor. Customer Service Specialists should educate patients of their financial responsibility when applicable. Job Duties: Develop and maintain a working knowledge of current products and services offered by the company Answer all calls and emails in a timely manner, in adherence to their goals Document all call information according to standard operating procedures Answer questions about products and services, retail stores, general service line information, and other information as necessary based on customer call needs Process orders, route calls to the appropriate resource, and follow up on customer calls where necessary Review all required documentation to ensure accuracy Accurately process, verify, and/or submit documentation and orders Complete insurance verification to determine the patient’s eligibility, coverage, co-insurances, and deductibles Obtain pre-authorization if required by an insurance carrier and process physician orders to insurance carriers for approval and authorization when required Must be able to navigate through multiple online EMR systems to obtain applicable documentation Enter and review all pertinent information in the EMR system including authorizations and expiration dates Communicate with Customer Service and Management on an ongoing basis regarding any noticed trends with insurance companies Verify insurance carriers are listed in the company’s database system, if not, request the new carrier is entered Responsible for contacting the patient when documentation received does not meet payer guidelines to provide updates and offer additional options to facilitate the referral process. Meet quality assurance requirements and other key performance metrics Facilitate resolution of customer complaints and problem-solving Pay attention to detail and have great organizational skills Actively listen to patients and handle stressful situations with compassion and empathy Be flexible with the actual work and the hours of operation Utilize company-provided tools to maintain quality. Some tools may include but are not limited to Authorization Guidelines, Insurance Guidelines, Fee Schedules, NPI (National Provider Identifier), PECOS (the Medicare Provider Enrollment, Chain, and Ownership System), and “How-To” documents Competency, Skills, and Abilities: Excellent customer service skills Analytical and problem-solving skills with attention to detail Decision Making Excellent ability to communicate both verbally and in writing Ability to prioritize and manage multiple tasks Proficient computer skills and knowledge of Microsoft Office Solid ability to learn new technologies and possess the technical aptitude required to understand the flow of data through systems as well as system interaction General knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation requirements preferred Work well independently and as part of a group Ability to adapt and be flexible in a rapidly changing environment, be patient, accountable, proactive, take initiative, and work effectively on a team Minimum Job Qualifications: High School Diploma or equivalent One (1) year work-related experience in health care administrative, financial, or insurance customer services, claims, billing, call center, or management regardless of the industry Senior level requires two (2) years of work-related experience and one (1) year of exact job experience Exact job experience is considered any of the above tasks in a Medicare certified AdaptHealth is an equal opportunity employer and does not unlawfully discriminate against employees or applicants for employment on the basis of an individual’s race, color, religion, creed, sex, national origin, age, disability, marital status, veteran status, sexual orientation, gender identity, genetic information, or any other status protected by applicable law. This policy applies to all terms, conditions, and privileges of employment, including recruitment, hiring, placement, compensation, promotion, discipline, and termination.

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