Customer Service Rep II - PHC

Customer Service Representative

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.

Responsibilities include:

• 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

Education/Experience:

• High School diploma or GED equivalency required
• Prefer 1 year of related health care, customer service, call center, or insurance experience
• Strong organization and communication skills required
• Must have basic computer and typing skills