About this role

This employee is a peer mentor for the department, responsible for setting a professional example in business acumen. This employee must accurately, thoroughly, and in a time-sensitive manner process patient orders and provide clear and timely communication to all stakeholders.

Proficient in and performs all Customer Service I and II core responsibilities
Respond to telephone inquiries and orders from patients and referral sources
May assist 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
May 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 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
Complete departmental projects as assigned
Peer to peer coaching as needed

Qualifications

Education/Experience:

High School diploma or GED equivalency required
Prefer 2 years of home health, customer service, call center, or insurance experience
Strong organization, communication, analytical, and problem-solving skills required
must have basic understanding of Microsoft Word, Excel, and excellent typing skills

Physical Demands:

The employee must occasionally lift and/or move up to 10 pounds.

Customer Service Rep III - PHC

Key skills

About this role