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Customer Service Specialist. Some tools may include but are not limited to Authorization Guidelines, Insurance Guidelines, Fee Schedules, NPI (National Provider Identifier), PECOS (the Medicare Provider Enrollment, Chain, and Ownership System) and "How-To" documents.
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Answer questions about products and services, retail stores, general service line information and other information as necessary based on customer call needs. The Customer Service Specialists works in a fast-paced environment answering inbound calls and making outbound calls.
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Customer Service Specialists are responsible for learning and understanding the entire front-end process to ensure successful service for our patients. Communicate with Customer Service and Management on an on-going basis regarding any noticed trends with insurance companies.
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Customer Service Specialists should educate Patients of their financial responsibility when applicable. Excellent customer service skills. At AdaptHealth we offer full-service home medical equipment products and services to empower patients to live their best lives – out of the hospital and in their homes.
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One (1) year work related experience in health care administrative, financial, or insurance customer services, claims, billing, call center or management regardless of industry. Process orders, route calls to appropriate resource, and follow up on customer calls where necessary.
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Facilitate resolution on customer complaints and problem solving. Obtain pre-authorization if required by an insurance carrier and process physician orders to insurance carriers for approval and authorization when required.
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General knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation requirements preferred. Complete insurance verification to determine patient's eligibility, coverage, co-insurances, and deductibles.
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Actively listens to patients and handle stressful situations with compassion and empathy. Must be able to navigate through multiple online EMR systems to obtain applicable documentation. Enter and review all pertinent information in EMR system including authorizations and expiration dates.
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Meet quality assurance requirements and other key performance metrics. Exact job experience is considered any of the above tasks in a Medicare certified. Verify insurance carriers are listed in the company's database system, if not request the new carrier is entered.
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Maybe responsible for obtaining, analyze, and verify the accuracy of information received from referrals, create orders, and or schedule the patient to receive equipment as ordered by their doctor. This policy applies to all terms, conditions, and privileges of employment, including recruitment, hiring, placement, compensation, promotion, discipline, and termination.
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Analytical and problem-solving skills with attention to detail. Ability to adapt and be flexible in a rapidly changing environment, be patient, accountable, proactive, take initiative and work effectively on a team.
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Responsible for contacting patient when documentation received does not meet payer guidelines to provide updates and offer additional options to facilitate the referral process. Document all call information according to standard operating procedures.
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Develop and maintain working knowledge of current products and services offered by the company. If you are passionate about making a profound impact on the quality of patients' lives, please click to apply, we would love to hear from you.
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Pays attention to detail and has great organizational skills. Senior level requires two (2) years of work-related experience and one (1) year of exact job experience. Proficient computer skills and knowledge of Microsoft Office.
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Solid ability to learn new technologies and possess the technical aptitude required to understand flow of data through systems as well as system interaction. Accurately process, verify, and/or submit documentation and orders.
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customer service specialist provider enrollment jobs Title: customer service
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