Career Details
Customer Service Full-Time Baltimore, MD Posted on 1/7/2025
Coordinates the admission process to maintain departmental policies and procedures to ensure that the level of treatment and supplies are appropriate to all patient’s needs.
• Strict adherence to the Company policy and procedure manual including state and federal laws.
• Responds to incoming calls from referral sources and/or potential patients, exchanges information to identify the organization’s ability to meet the needs of the patient, on a case-by-case basis.
• Reviews patient acceptance and all relevant information to ensure patients’ smooth transition to home care and contacts referral sources to advise of referral status, and provides to the clinical team who will deliver the services requested, OR;
• Assists referral sources and/or patients with alternative community resources or equipment providers when the Company is unable to meet the needs of the referral source and/or patient.
• Documents and routes all call in a manner consistent with the organization’s policies and procedures. Conducts courtesy follow-up calls, as required by Company policy and procedure.
• Identifies potential payer sources, verifies benefits with payer sources (as required by department organizational structure).
• Monitors potential payer sources, verifies benefits with payer sources (as required by department organizational structure).
• Responsible for making sure that we obtain the correct documentation to qualify patients for equipment and supplies per insurance coverage guidelines including but not limited to physicians’ orders, physician face to face documentation, physicians RX, physicians clinical notes as it pertains to the order and letters of medical necessity.
• Reviews clinical notes to ensure diagnosis and physician notes meet the requirements to receive the supplies/equipment ordered
• Documents conversations with payer sources.
• Accesses national or regional account information, including the names of accounts and terms of the contracts as appropriate and communicates these conversations to appropriate department staff as needed.
• Works with the all departments, referrals and patients to identify potential solutions as problems are identified with payer sources.
• Keeps all patients’ electronic charts orderly.
• Keeps reports up to date.
• Works closely with staff and referral sources to ensure equipment/supplies are ready at discharge.
• Communicates customer service issues to management and other departments as appropriate.
• Participates in Improvement of Operational Performance (IOP) activities.
• Participates in traditional and e-learning (VGMU) programs.
• Works effectively with other company employees, managers, and departments.
• Performs all job functions with Company Mission, Vision, and Goal Statements in mind.
• All other duties as assigned.
Education, Certificate, and Licensure
High school diploma or general education degree (GED); three years related experience and/or training; or equivalent combination of education and experience. No professional certificate or licensure required, although preferred.
Requirements
Must demonstrate proficient ability and practical knowledge of computers, software, and products applicable to the industry. Additionally, the applicant is expected to demonstrate the ability to quickly acquire knowledge of departmental program structure (Mission, Vision, and Goal Statements) and department policies and procedures. Must be able to work a flexible schedule, as needed, and have the ability to demonstrate effective time management skills while working independently with minimal supervision.
Math Ability
Must demonstrate proficient ability to apply mathematical concepts such as basic tasks as calculating figures and amounts, to practical situations.
Supervisory Requirements
This job has no supervisory requirements or authority
Language and Communication Ability
Must demonstrate proficient ability to foster professional working relationships utilizing strong interpersonal and communication skills organization-wide. Applicant must demonstrate the ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, and/or governmental regulations and effectively present and debate any assortment of information relevant to their area of expertise and designated responsibilities and duties with members of the Company and on behalf of the Company when appropriate. Additionally, the applicant must demonstrate the ability to write reports, business correspondence, and procedure manuals.
Physical Demands
Must demonstrate the ability to work in a standard office setting and use standard office equipment, which may include but is not limited to: computers, fax and copy machines, and other office supplies. Requires stamina to maintain attention to detail despite interruptions; strength to lift and carry files weighing up to 10 pounds; vision to read printed materials and a computer screen; hearing and speech to communicate in person and over the phone; manual dexterity to perform job functions and stamina to frequently sit for extended periods of time. Additionally, the employee is occasionally required to walk and lift and/or move up to 20 pounds.
Reasoning Ability
Must demonstrate proficient ability to understand, apply, and interpret an extensive array of information, variables, and instruction where only limited standardization exists to define problems, collect data, establish facts, and draw valid conclusions.
Technology Skills
Must demonstrate proficient ability and practical knowledge of personal computer use, word processing software and accounting software. Additionally, the applicant must demonstrate the ability to quickly and proficiently learn to use company specific software programs and any other handheld or technology tools as required for completing job tasks.
Must demonstrate proficiency and productivity in a fast-paced environment with unscheduled interruptions while maintaining acceptable judgment, responsibility, and assumption for decisions, consequences, and results. Applicant must demonstrate good organization, time management, and communication skills. Occasionally an adjusted work schedule is required to accommodate company needs.
This job description has been assessed and found to have little to no potential risk of occupational exposure to hazardous chemicals, blood, or other potentially infectious materials. However, during the course of some duties it may be necessary to wear personal protective equipment (PPE). Before performing any activity that requires the use of PPE, proper training and certification is required.
The statements contained herein reflect general details as necessary to describe the principal functions of this job, the level of knowledge and skill typically required, and the scope of responsibility, but should not be considered an all-inclusive listing of work requirements.