Responsible for obtaining re-authorization requirements for on-going coverage of durable medical equipment.
Review and obtain necessary compliance documents, medical records and prescriptions in order to submit for re-authorization.
Responsible for assisting patients in the re-authorization process
Responsible for working with sales and clinical personnel to facilitate re-authorization tasks.
Review & work pending re-authorization tasks daily
Assist in the appeals process for denied re-authorizations
Travel as needed to provider’s office/clinic/hospital to obtain records for re-authorization.
Contact patients to coordinate any necessary doctor’s appointments needed in order to submit re-authorization
Notify RT/Sales teams regarding non-compliance and re-authorization deadlines that are not met
Establishes and maintains effective communication and good working relationship with co-workers for the patient’s benefit.
Performs other clerical tasks as needed, such as answering phones, faxing, and emailing.
Completes other duties, as assigned
Communicates appropriately and clearly to Manager/Supervisor, and other superiors. Reports all concerns or issues directly to Regional Sales Manager.
Qualifications:
Requirements:
Learns and maintains knowledge of current patient database and billing system
Ability to understand re-authorization requirements
General knowledge of government, regulatory billing and compliance regulations/policies for Medicare, Medicare Advantage, Commercial Insurance & Medicaid
Medical Terminology background
Enough knowledge of policies and procedures to accurately answer questions from internal and external customers.
Utilizes initiative; maintains set level of productivity goals with ability to consistently and accurately
Experience:
Clinical administrative experience preferred
Two years’ experience in insurance office, doctor's office, or three years’ general office experience.
Skills:
Superior organizational skill.
Attention to detail and accuracy.
Ability to work as part of a health care team.
Effectively communicate with physicians, patients, insurers, colleagues and staff
Proficient in Microsoft Office, including Outlook, Word, and Excel
