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Sleep Intake Specialist
2 months ago
Sleep Intake Specialist-Insurance verification
Job Category
:
Sleep Services
Requisition Number
:
SLEEP002097
Apply now
Full-Time
Locations
Showing 1 location
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position.
Obtains patient demographic and health insurance information; collects co-pay(s) when appropriate
Verifies and records insurance benefits, with the ability to understand and provide insurance breakdowns
Obtains prior authorization if required by payer(s)
Interacts professionally with physicians, patients, patients family and co-workers
Schedules set ups, as called into VieMed, by physicians or physician’s office staff, per policy and procedure
Retrieves incoming referral(s) and logs demographic information into current patient database & billing system
Reviews medical records from referral(s) to determine if medical necessity has been met
Communicates to sales team &/or referral source(s), if referral is acceptable or what is missing to complete referral(s)
Documents in computer system the status of referral
Reports all concerns or issues directly to Resupply Supervisor
Other responsibilities and projects as assigned
Qualifications
High School Diploma or equivalent
One (1) to two (2) years working for a Durable Medical Equipment company or relevant medical office experience preferred
Basic understandings of medical insurance benefits
Skill in establishing and maintaining effective working relationships with other employees, patients, organizations, and the public
Effectively communicate with physicians, patients, insurers, colleagues and staff
Able to read and understand medical documentation effectively
Knowledge and understanding of same and similar DME equipment
Knowledge and understanding of In-network vs Out of Network, PPO, HMO
Thorough understanding and maintaining of medical insurances company’s regulations and requirements to include but not limited to Medicare and Medicaid
Working knowledge of CPT, HCPCS & ICD10 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits.
Learns and maintains knowledge of current patient database & billing system
Up to date with health information technologies and applications
Answers telephone in a polite and professional manner. Communicates information to appropriate personnel and management in a timely manner
Establishes and maintains effective communication and good working relationships with co-workers, patients, organizations and the public
Proficient in Microsoft Office, including Outlook, Word, and Excel
Utilizes initiative, strives to maintain steady level of productivity and is self-motivated
Possible weekend work or overtime, to include working an on-call rotation schedule
Access to Protected Health Information (PHI)
This position will require the employee to handle Protected Health Information (PHI) for duties related to document and report preparation. Policies and procedures will be strictly adhered to make sure PHI is protected as required by the HIPAA Privacy Rule.
Working Conditions
This position will work in an office environment.
Qualifications
Skills
Behaviors
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Motivations
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Education
Experience
Licenses & Certifications
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)
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