LTC Customer Service Rep. (English/Spanish Required) In House Position

Job Description

Job Description

MAR-J MEDICAL SUPPLY INC.

Job Description

 

Job Title: Brightree Customer Service/ LTC Representative

Division: Warehouse

Department: Customer Service

Reports To: LTC Customer Service Manager

FLSA Status: Non-Exempt

 

Summary: Responsible for incoming and outgoing calls to and from patients, referral sources and physicians’ offices and or case managers pertaining to DME and incontinent supply inquires, verifying insurance eligibility and coverage via Brightree and insurance portals, logging Par's and attaching authorization to PAR identification number for new and recurring members by performing the following duties.

 

Duties and Responsibilities include the following. Other duties may be assigned.

 

1. Researching products and cost to align with payer reimbursement percentages, ensuring profitability.*

 

2. Constant research and refreshing on insurance guidelines and updates, with an emphasis on Medicare and Medicaid.*

 

3. Generate, request and follow up with referrals on Detailed Written Orders (DWO), incomplete prescriptions, incomplete documentation etc.*

 

4. Ability to perform complex repetitive work with frequent interruptions without losing patience or focus while maintaining a low error rate.*

 

5. Manage assigned WIP orders and Tasked items on a daily basis to ensure accurate and timely billing.*

 

6. Demonstrates a high degree of personal responsibility and accountability to the quality of their work.*

 

7. Ability to track Refills based on prescription, setup template for specified time span.*

 

8. Collect sensitive patient billing information such as credit card details.*

 

 

 

9. Log and record any complaints in Brightree, as well as notating account with any pertinent information.*

 

10. Other duties as assigned.*

 

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

Language Ability:

Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.

****Bilingual / Spanish speakers welcome

Math Ability:

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.

 

Reasoning Ability:

Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions. Ability to deal with problems involving a few concrete variables in standardized situations.

 

Computer Skills:

To perform this job successfully, an individual should have knowledge of Word, Outlook, Excel.

 

Education/Experience:

High school diploma or general education degree (GED); and one year related experience and/or training; or equivalent combination of education and experience.

 

Knowledge, Skills, and Other Abilities:

· Basic Knowledge of Medicaid DME Fee Schedule

· Basic Knowledge of MMA and or LTC plans

· Excellent Time Management skills

· Professionalism

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

While performing the duties of this job, the employee is regularly required to sit, use hands, reach with hands and arms, and talk or hear. The employee is frequently required to walk. Specific vision abilities required by this job include close vision.

Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

The noise level in the work environment is usually moderate.