Prism Health Care Services
This is a full-timeday position Monday-Friday, 8:30am-5pm. This position is an in-officeposition at our location in Schaumburg, IL. At least 1 year of previous experience required.
Basic Function: Under the direction of the Financial Services Lead, this position is responsible for all documentation activities relating to timely transitions of care.
Requirements:
High school diploma or equivalent.
Minimum of one-year experience in DME or Medical Office Customer Service.
Proven performance record in customer service.
Strong knowledge of federal and state regulations
Demonstrates ability to work successfully with internal and external contacts
Strong collaborative and skills in facilitating teamwork
Ability to work independently
Demonstrate excellent oral and written communication, problem solving, investigational and analytical skills along with excellent listening and interpersonal skills
Ability to multi-task, prioritize and manage time effectively
ADA CHECKLIST FOR PHYSICAL ACTIVITIES and REQUIREMENTS, VISUAL ACUITY, AND WORKING CONDITIONS OF THE POSITION The following is a list of abilities required for this position, unless reasonable accommodations can be made in accordance with the Americans With Disabilities Act (ADA).
Physical Activity – Sedentary work, exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time at employee workstation. Occasionally move about the inside of the office to access office machinery, file cabinets, or attend meetings.
Talking – Expressing or exchanging ideas by means of the spoken word. Those activities in which they must convey detailed or important spoken instructions to other workers or customers accurately.
Visual Acuity – The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures or viewing a computer terminal.
Hearing – Perceiving the nature of sounds at normal speaking levels with or without correction. Ability to receive detailed information through oral communication, and to make the discriminations in sound.
Conditions – The worker is not substantially exposed to adverse environmental conditions, tasks are completed in an office environment.
Finger Dexterity – Typing or otherwise working, primarily with fingers rather than with the whole hand as in handling. Constantly operates a computer and other office productivity equipment, such as a desk telephone, cellphone, calculator, copy machine, and computer printer.
JOB POSITION DESCRIPTION Principle Responsibilities:
Gathers documentation needed to support medical necessity to submit Prior Authorization for Durable Medical Equipment.
Submit and maintain prior authorizations
Submit and maintain all certificate of medical necessity (CMN)
Receives appropriate paperwork and prescriptions as required
Request documentation pertaining to continued need for PAP and Oxygen patients
Review and Complete Stop/Hold report for documentation related stops and holdsEnters all patient notes into EMR and verifies all information is complete and accurate
Knowledge of Medicare LCD’s and Qualifications for home medical equipment
Maintain current knowledge of Medicare, Illinois Public Aid and insurance industry policies and guidelines
Interacts in strict adherence to HIPPA compliance regulations and related company policies
Upload required documents to the patient account
Responds to customer requests courteously and with respect
Approaches customers and inquiries in a manner which represents ownership
Resolves customer complaints by investigating problems and making recommendations to executive leadership
Refers troubleshooting calls to appropriate department
Reports any patient or referral related problems to Lead immediately
Build and maintain positive relationships with referral sources to include education on medical equipment qualification and policy changes
Promote company program and services to assigned referral source.
Meets monthly and quarterly productivity goals
Adherence to the Prism’s Employee Handbook
Adherence to Prism’s Policies and Procedures
Supports the mission, vision and strategic plan of the organization.
Contributes to team effort by accomplishing related results
Communicate necessary information to the Managers and Co-workers
Participate in on-call schedule rotation
Attend in-service training when required
Performs other duties as assigned
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Basic Function: Under the direction of the Financial Services Lead, this position is responsible for all documentation activities relating to timely transitions of care.
Requirements:
High school diploma or equivalent.
Minimum of one-year experience in DME or Medical Office Customer Service.
Proven performance record in customer service.
Strong knowledge of federal and state regulations
Demonstrates ability to work successfully with internal and external contacts
Strong collaborative and skills in facilitating teamwork
Ability to work independently
Demonstrate excellent oral and written communication, problem solving, investigational and analytical skills along with excellent listening and interpersonal skills
Ability to multi-task, prioritize and manage time effectively
ADA CHECKLIST FOR PHYSICAL ACTIVITIES and REQUIREMENTS, VISUAL ACUITY, AND WORKING CONDITIONS OF THE POSITION The following is a list of abilities required for this position, unless reasonable accommodations can be made in accordance with the Americans With Disabilities Act (ADA).
Physical Activity – Sedentary work, exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time at employee workstation. Occasionally move about the inside of the office to access office machinery, file cabinets, or attend meetings.
Talking – Expressing or exchanging ideas by means of the spoken word. Those activities in which they must convey detailed or important spoken instructions to other workers or customers accurately.
Visual Acuity – The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures or viewing a computer terminal.
Hearing – Perceiving the nature of sounds at normal speaking levels with or without correction. Ability to receive detailed information through oral communication, and to make the discriminations in sound.
Conditions – The worker is not substantially exposed to adverse environmental conditions, tasks are completed in an office environment.
Finger Dexterity – Typing or otherwise working, primarily with fingers rather than with the whole hand as in handling. Constantly operates a computer and other office productivity equipment, such as a desk telephone, cellphone, calculator, copy machine, and computer printer.
JOB POSITION DESCRIPTION Principle Responsibilities:
Gathers documentation needed to support medical necessity to submit Prior Authorization for Durable Medical Equipment.
Submit and maintain prior authorizations
Submit and maintain all certificate of medical necessity (CMN)
Receives appropriate paperwork and prescriptions as required
Request documentation pertaining to continued need for PAP and Oxygen patients
Review and Complete Stop/Hold report for documentation related stops and holdsEnters all patient notes into EMR and verifies all information is complete and accurate
Knowledge of Medicare LCD’s and Qualifications for home medical equipment
Maintain current knowledge of Medicare, Illinois Public Aid and insurance industry policies and guidelines
Interacts in strict adherence to HIPPA compliance regulations and related company policies
Upload required documents to the patient account
Responds to customer requests courteously and with respect
Approaches customers and inquiries in a manner which represents ownership
Resolves customer complaints by investigating problems and making recommendations to executive leadership
Refers troubleshooting calls to appropriate department
Reports any patient or referral related problems to Lead immediately
Build and maintain positive relationships with referral sources to include education on medical equipment qualification and policy changes
Promote company program and services to assigned referral source.
Meets monthly and quarterly productivity goals
Adherence to the Prism’s Employee Handbook
Adherence to Prism’s Policies and Procedures
Supports the mission, vision and strategic plan of the organization.
Contributes to team effort by accomplishing related results
Communicate necessary information to the Managers and Co-workers
Participate in on-call schedule rotation
Attend in-service training when required
Performs other duties as assigned
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