Claims Representative Job at ProTech Medical
DUTIES/RESPONSIBILITIES:
Duties / Responsibilities include:
1. Regular and reliable onsite attendance
2. Comply with all applicable company policies, procedures, and patient protocols. Comply with all current government regulations and professional standards with respect to patient care.
3. Ability to receive walk in prescriptions at office for equipment needed. Ability to process referrals (speech devices, PAP devices and supplies, motorized wheelchairs, oxygen and nebulizers) as needed. This involves account creation in Brightree, insurance verification, order creation, acquiring authorizations and adding notes as needed in Brightree.
4. Maintain working relationship with referral sources and patients.
5. Ability to complete all necessary paperwork for walk in patients (delivery ticket, plan of care and other items needed to bill and meet accreditation standards with complete education of the product to the customer).
6. Review account to make sure all information is correct (address, insurance, MD, all contact numbers, emergency contact, and CAQH/PECOS) and link appropriate insurance, verify insurance, and submit authorizations..
7. Answer multi-line phone system efficiently and direct the patient to the correct person and/or department they need.
8. Scan and attach all referral documents and tickets daily.
9. Ability to have >98% accuracy on orders that are created.
10. Ability to work authorization requests/claims and follow ups within 24 hours.
11. Assist with implementation of quality improvement program to meet company and accreditation standards.
12. Ability to greet all customers with a positive attitude when providing updates on their prior authorization requests.
13. Ability to greet the customer, collect any deductible, process paperwork or any necessary information needed from the customer to help make their experience positive.
14. Ability to complete AR on a weekly basis and address all issues needed to ensure proper payment.
15. Ability to create accurate POs for purchasing new equipment.
16. Responsible for assisting other departments as needed in absence of other employees.
17. Maintain a clean, well-organized workspace.
18. Ability to file claims to insurance entities by way of electronic submission, mailouts or web portal entry.
19. Ensure all filed claims are paid properly and follow appeals process to a positive conclusion when required.
20. Maintain working knowledge of insurance guidelines and policies in accordance to equipment we provide.
21. Ability to maintain >98% accuracy on all claims that are billed.
All other duties as assigned
MINIMUM QUALIFICATIONS:
· Must be customer focused with the ability to deliver and demonstrate to all customers on daily use of any product received.
· Prior medical billing experience is required
· Prior DME experience is a plus, but not required
· Exceptional client focus and a natural ability to build relationships
· Maintain a strong sense of urgency
· Experience working in a fast-paced environment
· Effective verbal and written communication skills
· Drive to provide best-in-class service to our partners and customers
· Ability to work in a team stetting as well as independently to prioritize duties to meet deadlines
· Courteous Customer Service (internally and externally)
· Most love helping people (both internally and externally)
· High level attention to detail and ability to multi-task
· Positive influence on all co-workers and referral sources
· Able to manage multiple priorities and close the loop when interrupted
· Must be able to pass background and drug screenings
REQUIRED KNOWLEDGE:
Knowledge of computer systems and office machines
· Intermediate knowledge of Microsoft Outlook, Excel and other Microsoft products.
PHYSICAL DEMANDS:
Lift/move items up to 40 pounds
While performing the duties of this job, the employee is regularly required to sit, use hands to finger, handle or feel objects, tools, or controls; reach with hands and arms, and talk and hear.
The employee is required to sit and stand
Job Type: Full-time
Pay: $19.00 - $23.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Ability to commute/relocate:
- Columbia, TN 38401: Reliably commute or planning to relocate before starting work (Required)
Education:
- High school or equivalent (Preferred)
Experience:
- DME or Home Health: 1 year (Preferred)
Work Location: One location
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