Customer Service Representative

2 weeks ago

Asheville, North Carolina, United States AdaptHealth LLC Full time
Job Title: Customer Service Specialist

AdaptHealth LLC is seeking a highly skilled Customer Service Specialist to join our team. As a Customer Service Specialist, you will play a critical role in ensuring the successful service delivery to our patients.

Job Summary:

The Customer Service Specialist will be responsible for learning and understanding the entire front-end process to ensure successful service delivery to our patients. This includes answering inbound calls, making outbound calls, obtaining, analyzing, and verifying the accuracy of information received from referrals, creating orders, and scheduling patients to receive equipment as ordered by their doctor.

Key Responsibilities:
  • Develop and maintain working knowledge of current products and services offered by AdaptHealth LLC.
  • Answer all calls and emails in a timely manner, in adherence to our 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 appropriate resources, 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 patient 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 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 patients 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 on customer complaints and problem-solving.
  • Pays attention to detail and has great organizational skills.
  • Actively listens to patients and handles stressful situations with compassion and empathy.
  • Flexible with 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.
Requirements:
  • High School Diploma or equivalent.
  • One (1) year work-related experience in healthcare administrative, financial, or insurance customer services, claims, billing, call center, or management, regardless of 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 environment.

AdaptHealth LLC 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.

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