Job Description:
• Review medical records, clinical documentation, and payer guidelines to determine patient eligibility, qualification status, and compliance prior to service delivery
• Communicate with patients regarding financial responsibility, collect payments when applicable, and document interactions accurately
• Contact patients when documentation does not meet payer requirements, providing updates and alternative options to support timely care
• Work with referral sources, physicians, and clinical teams to obtain complete and compliant documentation
• Demonstrate expert knowledge of payer requirements to ensure services are provided appropriately and in compliance
• Maintain accurate, timely documentation of patient information and communications using electronic systems
• Accurately enter referrals within established timeframes while meeting productivity and quality standards
• Coordinate with leadership to ensure appropriate inventory and services are selected and scheduled
• Work closely with sales, insurance verification, and internal support teams to facilitate the referral and intake process
• Navigate multiple EMR and online systems to obtain and manage documentation
• Ensure appropriate shipping and delivery methods are selected in accordance with company procedures
• Answer incoming calls promptly and provide professional assistance to patients and referral sources
• Participate in on-call rotation during non-business hours in accordance with company policy
• Support team operations and quality standards by following company policies and procedures
• Perform other related duties as assigned
Requirements:
• One (1) year of relatable work experience required
• High School Diploma, Associate’s degree in relatable field, Healthcare Administration, Business Administration or equivalent work experience required
• Experience in management, administrative, clerical, insurance, billing, claims, call center, or customer service preferred but not required
• Experience within a healthcare organization, pharmacy, HME, medical supply, or Medicare-certified environment is a plus but not required
• Excellent verbal and written communication skills including analytical, problem-solving and decision-making abilities with attention to detail
• Ability to multi-task in a fast paced environment
• Proficient computer skills – Microsoft Office and healthcare systems are a plus
• Comfort learning new technologies and navigating multiple systems
• Ability to work independently while following established procedures and directives
• Company conducted Background Check is required for all roles
• Clinical roles require valid licensure/certification, where applicable
Benefits:
• Competitive Compensation and Incentives
• Comprehensive Total Rewards & Benefits
• Support, Development, and Advancement Opportunities
• Comprehensive medical, dental and vision coverage (eligible first of the month following hire)
• 401(k) with company match
• Paid Time Off Plans including 6 paid holidays
• Employee Stock Purchase Plan
• Paid Parental Bonding Leave
• Short and Long-term Disability Insurance
• Life and AD&D Insurance
• Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA)
• CVS Minute Clinic and Teledoc access
• Spousal Advantage Reimbursement Plan
• Identity Theft Protection and Legal Plan