Position Summary Under general supervision provides service directly to HHME customers including the selection of equipment/supplies and performs clerical tasks involved in processing and maintaining routine written materials used by the department. Performs tasks required for the proper billing of equipment/supplies including meeting third party payer requirements. Independently performs equipment/supply set-ups with customers, equipment/supply maintenance, equipment/supply troubleshooting, environmental assessment, customer/caregiver education and assists with discharge planning. Ensures all actions taken in carrying out responsibilities support patient centered care. Position Responsibilities Unit Specific Position Responsibilities Performs Intake functions Secures necessary information during the admission registration process Obtain, verify and maintain customer demographics and insurance information for billing purposes (i.e. admission, financial/cost, CMN, benefits and authorizations, etc#). Obtains both written, verbal and telephone orders from appropriate healthcare professionals. Obtain, review, verify and maintain medical documentation as required by third party payers/insurance for payment. Registers the patient on both the hospital#s computer software and the department#s computer software. Interviews patients to secure payments on accounts, determine if a patient may be in need of financial assistance, and to answer any billing questions. Performs billing functions Accurately posts charges to accounts with appropriate codes, modifiers and information. Monitors recurring accounts monthly and performs necessary follow-up such as rebilling, equipment usage verification and other requirements. Answer questions and resolve problems related to billing operations. Reviews and prepares documents for claim filing Works to resolve carrier denials for proper payment of claims including appeals and resubmission. Identifies potential discrepancies in claims payment processing. Handles inquires regarding claims/reports. Secure payments (Cash, check, payroll deduct, etc#) and maintains daily reconciliation/balancing documents per policy. Maintain current knowledge of carrier specific requirements by attending workshops and/or webinars and/or presentations, reading newsletters, reading manuals and acting as a liaison in carrier meetings. Initiates and coordinates prior authorization requests to third party payers and maintains a working knowledge of third party payer guidelines. Follows up with third party payers as necessary. Assists with inventory system by establishing new CDMs with required information, performing cost comparison, interacts with manufacturer representatives, adjusts inventory levels, and orders inventory. Operates computer system to accurately document and retrieve information in a timely manner. Specializes in one or more of the agency#s service lines, yet is responsible for having a basic knowledge of all service lines. Supports and assists in role of Equipment Representative when necessary Meets measures as determined and required for job productivity and performance improvement. Employee is responsible for completion of communication tasks and activities in a timely manner. This would include, but is not limited to: responding to email, voicemail or telephone messages, promptly, accurately, and professionally; attending staff meetings as scheduled or viewing videotapes of those meetings; asking questions of team members and supervisor when needing clarification about various day-to-day issues or patient needs; and reviewing employee communication pieces, such as The MGMCgram, to stay aware of MGMC/HHME programs and initiatives. Facilitate changes to improve processes as needed. Performs patient follow up phone calls as directed by manager. Interacts with patients, family, and caregivers in a friendly and professional manner on the phone, in the showroom and in the client#s home to ensure customer satisfaction. Coordinates the delivery and set-up of equipment. Performs other duties as requested by HHME Supervisor to facilitate the smooth and effective operations of the organization. Maintains compliance with OSHA, accreditation standards and risk management guidelines. Prepares and organizes work schedule to accommodate department priorities. Identifies priority conflicts when they exist and brings them to the attention of the Supervisor for resolution. Qualifications, Knowledge # Experience Required Qualifications (Including any licensure, certification, education): Knowledge of basic spelling, punctuation, grammar and basic business math. Valid driver#s license and meets MGMC#S insurance carrier requirements for coverage. Mandatory Reporter training within 90 days of hire and must maintain throughout employment. Preferred Qualifications: None Specified Required Knowledge, Skills # Experience: Ability to demonstrate clinical competence and maintain current knowledge in caring for adolescent through geriatric patients. Ability to communicate effectively both verbally and in writing. Skill in effective oral and written communication in English. Knowledge of basic arithmetic and application Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar. Active Listening skills, giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times. Moderate to advanced typing and/or computer keyboard skills. Knowledge of human relations skills Ability to establish and maintain effective working relationships with others. Ability to deal tactfully with the public Ability to handle confidential work with tact and discretion Ability to handle complex clerical tasks and routine decisions in accordance with policy. Preferred Knowledge, Skills # Experience: Knowledge of medical terminology, anatomy and physiology. Knowledge of medical billing practices. One year of medical experience; preferably in community home health or home medical equipment. Previous experience leading to exposure to general clerical routines and procedures / development of special clerical skills Knowledge of general office practices and procedures.
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