Duties:
Responsible for obtaining re-authorization requirements for on-going coverage of durable medical equipment.Review and obtain necessary compliance documents, medical records and prescriptions in order to submit for re-authorization.Responsible for assisting patients in the re-authorization processResponsible for working with sales and clinical personnel to facilitate re-authorization tasks.Review & work pending re-authorization tasks dailyAssist in the appeals process for denied re-authorizationsTravel as needed to provider's office/clinic/hospital to obtain records for re-authorization.Contact patients to coordinate any necessary doctor's appointments needed in order to submit re-authorizationNotify RT/Sales teams regarding non-compliance and re-authorization deadlines that are not metEstablishes and maintains effective communication and good working relationship with co-workers for the patient's benefit.Performs other clerical tasks as needed, such as answering phones, faxing, and emailing.Completes other duties, as assignedCommunicates appropriately and clearly to Manager/Supervisor, and other superiors. Reports all concerns or issues directly to Regional Sales Manager.Requirements:
- Learns and maintains knowledge of current patient database and billing system
- Ability to understand re-authorization requirements
- General knowledge of government, regulatory billing and compliance regulations/policies for Medicare, Medicare Advantage, Commercial Insurance & Medicaid
- Medical Terminology background
- Enough knowledge of policies and procedures to accurately answer questions from internal and external customers.
- Utilizes initiative; maintains set level of productivity goals with ability to consistently and accurately
Experience:
- Clinical administratvie experience preferred
- Two years' experience in insurance office, doctor's office, or three years' general office experience.
Skills:
- Superior organizational skill.
- Attention to detail and accuracy.
- Ability to work as part of a health care team.
- Effectively communicate with physicians, patients, insurers, colleagues and staff
- Proficient in Microsoft Office, including Outlook, Word, and Excel
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)