Customer Service Rep II
3 weeks ago
This employee serves as the subject matter expert in all Customer Service responsibilities, primarily responsible for accurately, thoroughly, and in a time-sensitive manner, processing patient orders and providing clear and timely communication to all stakeholders.
- Responds to telephone inquiries and orders from patients and referral sources
- May assist walk-in patients with the selection of equipment, supplies, and services
- Determines resolution of patient and referral inquiries, questions, or concerns
- Identifies concerns and ensures they are recorded in Concern Tracker system when appropriate
- Completes electronic intake process in billing system, performs verification of insurance, and reviews all documentation for accuracy in order to qualify patient for services
- Contacts patients to inform them of any patient payment requirements, collects payment, and determines best delivery method, providing instructions for receiving delivery
- Understands and abides by Accreditation Commission for Health Care (ACHC) requirements
- May need to understand and interpret Medicare guidelines and qualifying documentation
- Thoroughly understands payer and utilization guidelines
- May process insurance authorization and follow up on requests as needed
- Establishes positive relationships with referral sources and builds rapport with internal and external customers
- May be required to perform quality assurance process, confirming accuracy of orders prior to submission for reimbursement
- Understands C-PAP compliance guidelines as required by assignment, or has obtained knowledge of rehab specialty equipment and coverage criteria
- Consistently meets Quality Assurance score of 85% or above
Education/Experience:
- High School diploma or GED equivalency required
- Prefer 1 year of related health care, customer service, call center, or insurance experience
- Strong organization and communication skills required
- Must have basic computer and typing skills
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