Description

Duties:

1. Responsible for obtaining re-authorization requirements for on-going coverage of durable medical equipment.
2. Review and obtain necessary compliance documents, medical records and prescriptions in order to submit for re-authorization.
3. Responsible for assisting patients in the re-authorization process
4. Responsible for working with sales and clinical personnel to facilitate re-authorization tasks.
5. Review & work pending re-authorization tasks daily
6. Assist in the appeals process for denied re-authorizations
7. Travel as needed to provider's office/clinic/hospital to obtain records for re-authorization.
8. Contact patients to coordinate any necessary doctor's appointments needed in order to submit re-authorization
9. Notify RT/Sales teams regarding non-compliance and re-authorization deadlines that are not met
10. Establishes and maintains effective communication and good working relationship with co-workers for the patient's benefit.
11. Performs other clerical tasks as needed, such as answering phones, faxing, and emailing.
12. Completes other duties, as assigned
13. Communicates 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 administrative 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
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

PI281137636