Customer Service Rep II - PHC

About the role

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.

Responsibilities

• Responds to telephone inquiries and orders from patients and referral sources
• Aid walk-in patients with the selection of equipment, supplies, and services
• Determine resolution of patient and referral inquiries, questions, or concerns
• Identify concerns and ensure they are recorded in Concern Tracker system when appropriate
• Complete electronic intake process in billing system, perform verification of insurance, and review all documentation for accuracy in order to qualify patient for services
• Contact patients to inform them of any patient payment requirements, collect payment, and determine best delivery method, providing instructions for receiving delivery
• Understand and abide by Accreditation Commission for Health Care (ACHC) requirements
• May need to understand and interpret Medicare guidelines and qualifying documentation
• Thoroughly understand payer and utilization guidelines
• Process insurance authorization and follow up on requests as needed
• Establish positive relationships with referral sources and build rapport with internal and external customers
• May be required to perform quality assurance process, confirming accuracy of orders prior to submission for reimbursement
• Understand C-PAP compliance guidelines as required by assignment, or have obtained knowledge of rehab specialty equipment and coverage criteria
• Consistently meet Quality Assurance score of 85% or above