Customer Service Representative
Procare Ambulance
Job Type
Full-time, Part-time
Procare's Customer Service Respresentative will work out of the Communications Center supporting the communication specialist with answering telephones in a professional and courteous manner and handles questions or directs callers appropriately. Must be able to communicate effectively verbally so that others can hear and understand clearly what is being said. Must input transports into CAD including all demographic information for patient, performs all tasks necessary including verifying insurance eligibility and medical necessity, obtaining payment for medical transports, and inputting transport requests. Communication Specialist will also be responsible to set up Baltimore County MA transports with MA vendor and must be able to enter data accurately and consistently. Effective communication and accurate data entry are essential functions of this job. Customer Service Representative does not schedule transport requests unless directed by Communication Specialist. Qualification Requirements:
- Ability to interpret documents such as medical necessity forms and other medical documents, Medicare guidelines, rules and regulations, and an understanding of the various types of insurance.
- Ability to write reports and other correspondence effectively
- Ability to communicate effectively and professionally to customers, patients or employees.
- Ability to perform basic math skills to include addition, subtraction, multiplication, and division
- Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
- Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
- Must maintain strict confidentiality regarding all information pertaining to company policies, pricing, contract terms, patient data, forms, manuals, charts, or any other sensitive or confidential information obtained while employed at Procare.
- Ability to stand, walk, sit and stoop, kneel, or crouch.
- Ability to occasionally lift and/or move up to 20 pounds.
- Specific vision abilities required by this job include close vision, distance vision, color vision, and the ability to adjust focus.
- Answering Telephone calls and directing callers as appropriate
- Fully Verifying insurance and obtaining pre-authorizations
- Using dispatch software to enter transports as they are requested.
- Enter prescheduled calls
- Communicate effectively any issues or concerns to Com Center Specialist
- Ensure that all information is entered into the dispatch system
- Employee may be required to collect paperwork or payments or run credit card payments
- Make copies/scanning as requested
- Correspond with crews with regard to level of care, call scheduling, call completion and any other issues that arise as directed by Com Center Specialist
- Provide information to team as requested
- Ensure high quality of customer service and professionalism with all clients and other callers
- Take messages as they come in and give to appropriate person
- Use Scheduling software
- Attend meetings as requested by management
- Work as a team player at all times working to always find a mutually beneficial resolutions to any issue
- Assist other office staff members as required or requested. Must maintain strict confidentiality regarding all information pertaining to company policies, pricing, contract terms, patient data, forms, manuals, charts, or any other sensitive or confidential information obtained while employed at Procare. Due to the extremely sensitive nature of this position, this duty of strict confidentiality extends beyond the term of employment.
- Predetermine Medical Necessity for ambulance transports, if appropriate.
- Establish with patient that Procare is a separate entity and will invoice separately. While the ambulance service is part of the patient experience, it is not part of the hospital stay.
- Confirm the insurance information and/or obtain accurate insurance information from the patient. Confirm that the patient is uninsured, if applicable. Access Insurance Verification system remotely to verify insurance eligibility.
- Call patient's insurance company to ascertain coverage for transport and any copay or other payment assigned to patient by insurance company. Collect payments up front via credit card.
- Establish patient financial responsibility, if any, and gain acknowledgement of the same from the patient.
- Obtain payment up front for all wheelchair van patients and uninsured patients who do not qualify for charity (including copay, if appropriate).
- Set up transports with the Baltimore County MA vendor, as appropriate.
- Understand different MA and Medicare insurance products, their application and ensure coverage by utilizing proper vendor.
- Call to let nursing staff know when we are 20 minutes prior to arrival so that facility knows we are on the way and patient is ready.
- Compliance with HIPAA
Vacancy posted 5 days ago
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