Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this
Retrieves incoming referral(s) from portals.
Reviews medical records from referral(s) to determine if medical necessity has been met.
Communicates to sales team &/or referral source(s), if the referral is acceptable or what is missing to complete referral(s)
Interacts professionally with physicians, patients, patient’s family, and co-workers.
Schedules set ups, as called into VieMed, by physicians or physician’s office staff, per policy and procedure.
Documents in the computer system the status of the referral
Assist to complete all open referrals
Check network status
Sends weekly updates to sales team on missing referrals.
Reports all concerns or issues directly to Intake Manager or Intake Supervisor
Other responsibilities and projects as assigned.
Qualifications
High School Diploma or equivalent
One (1) to two (2) years working for a Durable Medical Equipment company or relevant medical office experience preferred.
Basic understanding of medical insurance benefits
Skill in establishing and maintaining effective working relationships with other employees, patients, organizations, and the public.
Effectively communicate with physicians, patients, insurers, colleagues, and staff
Able to read and understand medical documentation effectively.
Knowledge and understanding of same and similar DME equipment.
Knowledge and understanding of In-network vs Out of Network, PPO, HMO
Thorough understanding and maintaining of medical insurance company’s regulations and requirements including but not limited to Medicare and Medicaid.
Working knowledge of CPT, HCPCS & ICD10 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, and insurance benefits.
Learns and maintains knowledge of current patient database & billing system.
Up to date with health information technologies and applications
Answers telephone in a polite and professional manner. Communicates information to appropriate personnel and management in a timely manner.
Establishes and maintains effective communication and good working relationships with co-workers, patients, organizations, and the public.
Proficient in Microsoft Office, including Outlook, Word, and Excel
Utilizes initiative, strives to maintain steady level of productivity and is self-motivated.
Work week is Monday through Friday and candidates will work an agreed-upon shift (current shifts include 7am-4pm, 8am-5pm, 9am-6pm of 10am-7pm)
Possible weekend work or overtime, to include working an on-call rotation schedule.
Access to Protected Health Information (PHI)
This position will require the employee to handle Protected Health Information (PHI) for duties related to document and report preparation. Policies and procedures will be strictly adhered to make sure PHI is protected as required by the HIPAA Privacy Rule.
Working Conditions
This position will work in an office environment.
Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
Equal employment opportunity, including veterans and individuals with disabilities.
