Customer Service Specialist - (Mon-Fri 9:30am-6pm)
AdaptHealth, LLC., Riverside, CA, United States
Overview
Customer Service Specialist - (Mon-Fri 9:30am-6pm)
Riverside, CA, USA
Responsibilities
Job Description posted Friday, June 4, 2021 at 4:00 AM. AdaptHealth is a premier full-service home medical equipment company in the United States – offering a full-scope of cost-efficient HME and respiratory care products and services that aim to keep patients comfortable and thriving in their own homes. We are dedicated to pursuing better and use technology, process and the power of our national network to do so. We have a relentless commitment to using innovation to transform the durable medical equipment industry, break the status quo and provide the best quality care.
Position Summary:
Customer Service Specialists are responsible for learning and understanding the entire front-end process to ensure successful service for our patients. The Customer Service Specialist works in a fast-paced environment answering inbound calls and making outbound calls. They may be responsible for obtaining, analyzing, and verifying the accuracy of information received from referrals, creating orders, and/or scheduling the patient to receive equipment as ordered by their doctor. Customer Service Specialists should educate patients of their financial responsibility when applicable.
Essential Functions and Job Responsibilities:
Develops and maintains working knowledge of current products and services offered by the company
Answers all calls and emails in a timely manner, in adherence to their goals
Documents all call information according to standard operating procedures
Answers questions about products and services, retail stores, general service line information and other information as necessary based on customer call needs
Processes orders, routes calls to appropriate resource, and follows up on customer calls where necessary
Reviews all required documentation to ensure accuracy
Accurately process, verify, and/or submit documentation and orders
Completes insurance verification to determine patient’s eligibility, coverage, co-insurances, and deductibles
Obtains pre-authorization if required by an insurance carrier and processes physician orders to insurance carriers for approval and authorization when required
Navigates through multiple online EMR systems to obtain applicable documentation
Enters and reviews all pertinent information in EMR system including authorizations and expiration dates
Communicates with Customer Service and Management on an ongoing basis regarding any noticed trends with insurance companies
Verifies insurance carriers are listed in the company’s database system; if not, requests the new carrier be entered
Contacts patient when documentation received does not meet payer guidelines to provide updates and offers additional options to facilitate the referral process
Meets quality assurance requirements and other key performance metrics
Facilitates resolution on customer complaints and problem solving
Pays attention to detail and has great organizational skills
Actively listens to patients and handles stressful situations with compassion and empathy
Remains flexible with the actual work and the hours of operation
Utilizes company provided tools to maintain quality. Tools may include but are not limited to Authorization Guidelines, Insurance Guidelines, Fee Schedules, NPI, PECOS and “How-To” documents
Develops and maintains working knowledge of current HME products and services offered by the company
Maintains patient confidentiality and functions within the guidelines of HIPAA
Completes assigned compliance training and other educational programs as required
Maintains compliance with AdaptHealth’s Compliance Program
Assists operations with on-call responsibilities as needed during non-business hours in accordance with company policy
May assist Operations with deliveries
Retains knowledge of and consistently adheres to procedures for the use of PPE, infection control and hazardous materials handling
Performs other related duties as assigned
Competency, Skills and Abilities:
Analytical and problem-solving skills with attention to detail
Decision making skills
Excellent ability to communicate both verbally and in writing
Ability to prioritize and manage multiple tasks
Proficient computer skills and knowledge of Microsoft Office
Solid ability to learn new technologies and possess the technical aptitude required to understand flow of data through systems as well as system interaction
General knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation requirements preferred
Works well independently and as part of a group
Ability to adapt and be flexible in a rapidly changing environment, remains patient, accountable, proactive, takes initiative and works effectively on a team
Education and Experience Requirements:
High School Diploma or equivalent
One (1) year work related experience in health care administrative, financial, or insurance customer services, claims, billing, call center or management regardless of industry
Senior level requires two (2) years of work-related experience and one (1) year of exact job experience
Exact job experience is considered any of the above tasks in a Medicare certified environment
Physical Demands and Work Environment:
Work environment may be stressful at times, as overall office activities and work levels fluctuate
Must be able to bend, stoop, stretch, stand, and sit for extended periods of time
Subject to long periods of sitting and exposure to computer screen
Ability to perform repetitive motions of wrists, hands, and/or fingers due to extensive computer use
Must be able to lift 30 pounds as needed
May be exposed to upset customers or patients
May be exposed to hazardous materials, loud noise, extreme heat/cold, direct, or indirect contact with airborne, bloodborne, and/or other potentially infectious pathogens
This position is primarily performed within an office building
Excellent ability to effectively communicate both verbally and in writing with customers with the ability to demonstrate empathy, compassion, courtesy, and respect for privacy
Medical
Vision
Paid Time Off
401k
EEO Statement:
AdaptHealth is an equal opportunity employer and does not unlawfully discriminate against employees or applicants for employment on the basis of an individual’s race, color, religion, creed, sex, national origin, age, disability, marital status, veteran status, sexual orientation, gender identity, genetic information, or any other status protected by applicable law. This policy applies to all terms, conditions, and privileges of employment, including recruitment, hiring, placement, compensation, promotion, discipline, and termination.
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Customer Service Specialist - (Mon-Fri 9:30am-6pm)
Riverside, CA, USA
Responsibilities
Job Description posted Friday, June 4, 2021 at 4:00 AM. AdaptHealth is a premier full-service home medical equipment company in the United States – offering a full-scope of cost-efficient HME and respiratory care products and services that aim to keep patients comfortable and thriving in their own homes. We are dedicated to pursuing better and use technology, process and the power of our national network to do so. We have a relentless commitment to using innovation to transform the durable medical equipment industry, break the status quo and provide the best quality care.
Position Summary:
Customer Service Specialists are responsible for learning and understanding the entire front-end process to ensure successful service for our patients. The Customer Service Specialist works in a fast-paced environment answering inbound calls and making outbound calls. They may be responsible for obtaining, analyzing, and verifying the accuracy of information received from referrals, creating orders, and/or scheduling the patient to receive equipment as ordered by their doctor. Customer Service Specialists should educate patients of their financial responsibility when applicable.
Essential Functions and Job Responsibilities:
Develops and maintains working knowledge of current products and services offered by the company
Answers all calls and emails in a timely manner, in adherence to their goals
Documents all call information according to standard operating procedures
Answers questions about products and services, retail stores, general service line information and other information as necessary based on customer call needs
Processes orders, routes calls to appropriate resource, and follows up on customer calls where necessary
Reviews all required documentation to ensure accuracy
Accurately process, verify, and/or submit documentation and orders
Completes insurance verification to determine patient’s eligibility, coverage, co-insurances, and deductibles
Obtains pre-authorization if required by an insurance carrier and processes physician orders to insurance carriers for approval and authorization when required
Navigates through multiple online EMR systems to obtain applicable documentation
Enters and reviews all pertinent information in EMR system including authorizations and expiration dates
Communicates with Customer Service and Management on an ongoing basis regarding any noticed trends with insurance companies
Verifies insurance carriers are listed in the company’s database system; if not, requests the new carrier be entered
Contacts patient when documentation received does not meet payer guidelines to provide updates and offers additional options to facilitate the referral process
Meets quality assurance requirements and other key performance metrics
Facilitates resolution on customer complaints and problem solving
Pays attention to detail and has great organizational skills
Actively listens to patients and handles stressful situations with compassion and empathy
Remains flexible with the actual work and the hours of operation
Utilizes company provided tools to maintain quality. Tools may include but are not limited to Authorization Guidelines, Insurance Guidelines, Fee Schedules, NPI, PECOS and “How-To” documents
Develops and maintains working knowledge of current HME products and services offered by the company
Maintains patient confidentiality and functions within the guidelines of HIPAA
Completes assigned compliance training and other educational programs as required
Maintains compliance with AdaptHealth’s Compliance Program
Assists operations with on-call responsibilities as needed during non-business hours in accordance with company policy
May assist Operations with deliveries
Retains knowledge of and consistently adheres to procedures for the use of PPE, infection control and hazardous materials handling
Performs other related duties as assigned
Competency, Skills and Abilities:
Analytical and problem-solving skills with attention to detail
Decision making skills
Excellent ability to communicate both verbally and in writing
Ability to prioritize and manage multiple tasks
Proficient computer skills and knowledge of Microsoft Office
Solid ability to learn new technologies and possess the technical aptitude required to understand flow of data through systems as well as system interaction
General knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation requirements preferred
Works well independently and as part of a group
Ability to adapt and be flexible in a rapidly changing environment, remains patient, accountable, proactive, takes initiative and works effectively on a team
Education and Experience Requirements:
High School Diploma or equivalent
One (1) year work related experience in health care administrative, financial, or insurance customer services, claims, billing, call center or management regardless of industry
Senior level requires two (2) years of work-related experience and one (1) year of exact job experience
Exact job experience is considered any of the above tasks in a Medicare certified environment
Physical Demands and Work Environment:
Work environment may be stressful at times, as overall office activities and work levels fluctuate
Must be able to bend, stoop, stretch, stand, and sit for extended periods of time
Subject to long periods of sitting and exposure to computer screen
Ability to perform repetitive motions of wrists, hands, and/or fingers due to extensive computer use
Must be able to lift 30 pounds as needed
May be exposed to upset customers or patients
May be exposed to hazardous materials, loud noise, extreme heat/cold, direct, or indirect contact with airborne, bloodborne, and/or other potentially infectious pathogens
This position is primarily performed within an office building
Excellent ability to effectively communicate both verbally and in writing with customers with the ability to demonstrate empathy, compassion, courtesy, and respect for privacy
Medical
Vision
Paid Time Off
401k
EEO Statement:
AdaptHealth is an equal opportunity employer and does not unlawfully discriminate against employees or applicants for employment on the basis of an individual’s race, color, religion, creed, sex, national origin, age, disability, marital status, veteran status, sexual orientation, gender identity, genetic information, or any other status protected by applicable law. This policy applies to all terms, conditions, and privileges of employment, including recruitment, hiring, placement, compensation, promotion, discipline, and termination.
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