Customer Service Rep, Durable Medical Equipment

Mercy Assisted Care, Inc.; Janesville (WI); On-site; USD 21,000 - 37,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Paid Time Off

Parental/Caregiver Leave

Tuition Reimbursement

Job summary

Mercyhealth seeks a detail-oriented Intake Associate to manage patient and referral calls, verify demographics and insurance, and process orders for equipment rentals or purchases.

Responsibilities include insurance approvals, Rx workflow reviews, and coordination with the purchasing team to fulfill Mercy system patient needs while ensuring regulatory compliance and timely follow-ups.

Qualifications

• High school diploma or equivalent; or 1 year’s related experience or training.

Responsibilities

• Handle patient and referral source calls to manage intake and scheduling.
• Verify patient demographics and insurance information for billing.
• Process insurance verifications and determine prior authorization needs.
• Enter accurate work order details and select supplies/equipment for delivery.
• Review prescriptions and Rx workflow; route faxes for processing.
• Coordinate with purchasing to subcontract orders as needed.
• Respond to customer issues and escalate as required.
• Maintain the auto reorder program and keep equipment data up to date.

Job description

Essential Duties and ResponsibilitiesManages phone calls from patients and referral sources.Responsible for intake of referral orders from phone calls, Epic and faxes, using departmental procedures.Performs insurance verification on each order to assess coverage, documentation and prior authorization needs.Obtains and reviews clinic notes, progress notes, orders, demographics, face-to-face and medical justification documentation from referrals to meet documentation expectations for Mercy Assisted Care per Federal, State and payer requirements.Maintains current knowledge of relevant documentation requirements for products provided by Mercy Assisted Care.Processes and submits prior authorizations for insurance approval of equipment rental or purchase.Responsible for entering accurate work order information, selecting appropriate supplies and/or equipment and delivery method for a seamless delivery. Maintains assigned Operator Tasks to ensure timely follow up with tasks.Schedules repairs for on-site repair technician.Reviews and obtains valid prescriptions through the Rx workflow.Reviews, routes and processes faxes through the fax workflow.Problem solves a wide range of customer issues and complaints, appropriately referring issues outside their scope of practice.Works with MAC purchasing department to subcontract orders from outside vendors for Mercy system patients.Must be able to select appropriate products given patient's medical need, life style and overall condition. Familiar with contraindication of all products and liability issues for MAC.Acts as liaison between Mercy Assisted Care and key internal and external customers/ referral sources.Responsible for maintaining and working the auto reorder program for suppliesMaintain up-to-date, accurate information regarding equipment to meet accreditation and regulatory requirements.Verify patient's demographic/insurance (payer) information to ensure accurate input to billing for reimbursement.Monitor reports for timely renewals of prescriptions, prior authorizations, rentals and missing information.Responsible for absorbing and applying information provided in Customer Service Huddles, Customer Service meetings and MAC all staff meetings.Education and ExperienceHigh school diploma or equivalent; or 1 year's related experience and/or training; or equivalent combination of education and experience.Certification and LicensureN/ASkills and AbilitiesN/ASpecial Physical DemandsThe Special Physical Demands are considered Essential Job Functions of the position with or without reasonable accommodations.While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel; reach with hands and arms and talk or hear. Must be able to read and write in English. The employee must occasionally lift and/or move up to 10 pounds. These Special Physical Demands are considered Essential Job Functions of the position with or without accommodations.Level of SupervisionN/ASupervisesN/APAY RANGE:$15.00 - $27.20Mercyhealth is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identify, national origin, disability, or protected veteran status.Mercyhealth offers competitive pay and a comprehensive benefits package including:Medical, Dental, VisionLife & Disability InsuranceFSA/HSA OptionsGenerous, accruing paid time offPaid Parental and caregiver leaveCareer advancement and educational opportunitiesTuition and certification reimbursementCertification ReimbursementWell-being ProgramsEmployee DiscountsOn-Demand PayFinancial EducationAnnual recognition/awards eventsPartner appreciation daysFamily entertainment/attractions discountCommunity service/improvement opportunitiesClick here for more details regarding Mercyhealth Careers Benefit Information.At Mercyhealth, we don’t simply hire people, we empower employee-partners who are passionate about making lives better. As an integrated health system, we deliver exceptional, coordinated across seven hospitals, 85 primary and specialty clinics, and a team of over 7,500 professionals serving northern Illinois and southern Wisconsin.Mercyhealth has been nationally recognized for our commitment to our people and culture, including:#1 in the nation on AARP's Best Employers for Workers Over 50One of Working Mother magazine's 100 Best Companies for Working MothersA Top 50 Company and Top 10 Nonprofit for Executive Women