Customer Service Rep II

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