Customer Service Rep II - PHC

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.

• Responds to telephone inquiries and orders from patients and referral sources

• May assist walk-in patients with the selection of equipment, supplies, and services

• Determines resolution of patient and referral inquiries, questions, or concerns

• Identifies concerns and ensures they are recorded in Concern Tracker system when appropriate

• Completes electronic intake process in billing system, performs verification of insurance, and reviews all documentation for accuracy in order to qualify patient for services

• Contacts patients to inform them of any patient payment requirements, collects payment, and determines best delivery method, providing instructions for receiving delivery

• Understands and abides by Accreditation Commission for Health Care (ACHC) requirements

• May need to understand and interpret Medicare guidelines and qualifying documentation

• Thoroughly understands payer and utilization guidelines

• May process insurance authorization and follow up on requests as needed

• Establishes positive relationships with referral sources and builds rapport with internal and external customers

• May be required to perform quality assurance process, confirming accuracy of orders prior to submission for reimbursement

• Understands C-PAP compliance guidelines as required by assignment, or has obtained knowledge of rehab specialty equipment and coverage criteria

• Consistently meets Quality Assurance score of 85% or above

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