Medical Service Representative

5 days ago

Des Moines, Iowa, United States AdaptHealth LLC Full time
Job Overview

AdaptHealth LLC is a leading provider of home medical equipment and services. As a Customer Service Specialist, you will play a critical role in ensuring the successful delivery of our services to patients across the country.

About the Role

We are seeking a highly motivated and customer-focused individual to join our team as a Customer Service Representative. In this role, you will be responsible for answering inbound calls, making outbound calls, and resolving customer inquiries in a timely and professional manner. Your primary goal will be to provide exceptional customer service, ensuring that patients receive the support they need to navigate our services effectively.

Key Responsibilities

The ideal candidate will have excellent communication and problem-solving skills, with the ability to work effectively in a fast-paced environment. You will be responsible for:
  • Developing and maintaining a working knowledge of our products and services;
  • Answering all calls and emails in a timely manner, adhering to our customer service goals;
  • Documenting all call information according to standard operating procedures;
  • Processing orders, routing calls to appropriate resources, and following up on customer calls as needed;
  • Reviewing all required documentation to ensure accuracy;
  • Accurately processing, verifying, and submitting documentation and orders;
  • Completing insurance verification to determine patient eligibility, coverage, co-insurances, and deductibles;
  • Obtaining pre-authorization if required by an insurance carrier and processing physician orders for approval and authorization when necessary;
  • Navigating multiple online EMR systems to obtain applicable documentation;
  • Entering and reviewing all pertinent information in the EMR system, including authorizations and expiration dates;
  • Communicating with customer service and management regarding any noticed trends with insurance companies;
  • Verifying insurance carriers are listed in our database system, requesting new carriers be entered if necessary;
  • Resolving customer complaints and problems in a timely and professional manner;
  • Maintaining quality assurance requirements and other key performance metrics.

Competency, Skills, and Abilities

To succeed in this role, you will need to possess the following competencies, skills, and abilities:
  • Excellent customer service skills;
  • Analytical and problem-solving skills with attention to detail;
  • Decision-making skills;
  • Excellent verbal and written communication skills;
  • Ability to prioritize and manage multiple tasks effectively;
  • Proficient computer skills and knowledge of Microsoft Office;
  • Solid ability to learn new technologies and understand data flow through systems;
  • General knowledge of Medicare, Medicaid, and commercial health plan methodologies and documentation requirements (preferred);
  • Ability to work independently and as part of a team; and
  • Flexibility to adapt to changing environments and priorities.

Minimum Job Qualifications

To be considered for this role, you must meet the following minimum qualifications:
  • High school diploma or equivalent;
  • One year of work-related experience in healthcare administrative, financial, or insurance customer services, claims, billing, call center, or management;
  • Senior-level candidates require two years of work-related experience and one year of exact job experience;
  • Exact job experience includes performing tasks similar to those described above in a Medicare-certified environment.

Compensation and Benefits

The estimated salary for this role is $45,000 - $65,000 per annum, depending on location and experience. AdaptHealth LLC offers a comprehensive benefits package, including health insurance, retirement plans, and paid time off. We are an equal opportunity employer and welcome applications from diverse candidates.

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