Customer Service Rep III - PHC

Responsibilities

• Set a professional example in business acumen.
• Process patient orders accurately, thoroughly, and in a time-sensitive manner.
• Provide clear and timely communication to all stakeholders.
• Respond to telephone inquiries and orders from patients and referral sources.
• Auxiliary in assisting 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 to qualify patient for services.
• Contact patients to inform them of any patient payment requirements, collect payment, and determine best delivery method to provide 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.
• Perform quality assurance process, confirming accuracy of orders prior to submission for reimbursement.
• Understand C-PAP compliance guidelines as required by assignment or has obtained knowledge of rehab specialty equipment and coverage criteria.
• Consistently meet Quality Assurance score of 85% or above.
• Provide coverage in all areas of assigned department as needed.
• Set the working example for other Patient Service employees in business acumen and knowledge.
• Peer to peer coaching as needed.