Customer Service Rep, Durable Medical Equipment

Mercy Health Corporation; Janesville (WI); On-site; USD 21,000 - 37,000; Full time

Benefits offered by this job

Medical, Dental, Vision

Life & Disability Insurance

FSA/HSA Options

Paid time off

Parental and caregiver leave

Tuition and certification reimburse

Job summary

Mercyhealth in Wisconsin seeks an intake specialist to manage patient and referral communications, verify insurance, and process prior authorizations for equipment rentals or purchases.

You will review clinic notes, demographics, and documentation to meet payer requirements and coordinate with internal teams to ensure timely delivery and accurate billing. Mercyhealth offers competitive pay and benefits.

Qualifications

• High school diploma or equivalent; or 1 year's related experience and/or training; or equivalent combination of education and experience.
• Special physical demands include ability to stand/walk/sit, lift up to 10 pounds, read and write in English.

Responsibilities

• Manages phone calls from patients and referral sources.
• Intake of referral orders from phone calls, Epic and faxes.
• Performs insurance verification on each order to assess coverage, documentation and prior authorization needs.
• Obtains and reviews clinic notes, progress notes, orders, demographics, and related documentation from referrals to meet Mercy Assisted Care requirements.
• Processes and submits prior authorizations for insurance approval of equipment rental or purchase.
• Responsible for entering accurate work order information and coordinating supplies/equipment and delivery methods.

Skills

High school diploma

Education

High school diploma or equivalent

Job description

Essential Duties and Responsibilities

• Manages 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 supplies
• Maintain 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 Experience

High school diploma or equivalent; or 1 year's related experience and/or training; or equivalent combination of education and experience.

Certification and Licensure

N/A

Skills and Abilities

N/A

Special Physical Demands

The 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 Supervision

N/A

Supervises

N/A

PAY RANGE:

$15.00 - $27.20

Mercyhealth 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, Vision
• Life & Disability Insurance
• FSA/HSA Options
• Generous, accruing paid time off
• Paid Parental and caregiver leave
• Career advancement and educational opportunities
• Tuition and certification reimbursement
• Certification Reimbursement
• Well-being Programs
• Employee Discounts
• On-Demand Pay
• Financial Education
• Annual recognition/awards events
• Partner appreciation days
• Family entertainment/attractions discount
• Community service/improvement opportunities

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 50
• One of Working Mother magazine's 100 Best Companies for Working Mothers
• A Top 50 Company and Top 10 Nonprofit for Executive Women