Customer Service Specialist - JD

Customer Service Specialist - JD

Customer Service Specialist - JD

Newton, IA

Description

AdaptHealth Opportunity - Today!

At AdaptHealth we offer full-service home medical equipment products and services to empower patients to live their best lives - out of the hospital and in their homes. We are actively recruiting in your area. If you are passionate about making a profound impact on the quality of patients' lives, please click to apply, we would love to hear from you.

Customer Service Specialist

Customer Service Specialists are responsible for learning and understanding the entire front-end process to ensure successful service for our patients. The Customer Service Specialists works in a fast-paced environment answering inbound calls and making outbound calls. Maybe responsible for obtaining, analyze, and verify the accuracy of information received from referrals, create orders, and or schedule the patient to receive equipment as ordered by their doctor. Customer Service Specialists should educate Patients of their financial responsibility when applicable.

Job Duties:

Develop and maintain working knowledge of current products and services offered by the company

Answer all calls and emails in a timely manner, in adherence to their 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 resource, 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's 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 on-going 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 patient 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 handle stressful situations with compassion and empathy

Flexible with the 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 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

Minimum Job Qualifications:

High School Diploma or equivalent

One (1) year work related experience in health care 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.