Customer Service Rep, Durable Medical Equipment

Mercy Assisted Care, Inc.; United States; On-site; USD 2,066,000 - 3,747,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

FSA/HSA Options

Paid time off

Job summary

Mercyhealth is seeking an intake coordinator to manage patient and referral calls, verify insurance, and process orders and authorizations. You will review records, ensure accuracy, and coordinate with the purchasing team to meet regulatory requirements.

The role requires basic high school education and English literacy, with a focus on accurate data entry and customer service in a health system setting. Join a team delivering essential health services in the region.

Qualifications

• High school diploma or equivalent; or 1 year's related experience and/or training; or equivalent combination of education and experience.
• Must be able to 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 documentation from referrals.
• Maintains current knowledge of documentation requirements for Mercy Assisted Care products.
• Processes and submits prior authorizations for insurance approval of equipment rental or purchase.
• Enter work order information and select supplies/equipment and delivery method.
• Schedule repairs for on-site repair technician.
• Review prescriptions through Rx workflow and process faxes.
• Problem-solve customer issues and refer outside scope when needed.
• Liaise between Mercy Assisted Care and internal/external customers.

Skills

Phone calls handling

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

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.

Benefits

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 For over 135 years, Mercyhealth has provided high-quality health care to residents throughout northern Illinois and southern Wisconsin.

We have a passion for providing comprehensive health care close to home for area residents through our six hospitals and 85 primary and specialty care locations. As an integrated health system, you can come to us for routine health care, like annual physicals, immunizations and preventive health screenings, as well as highly specialized care, such as neonatal intensive care, heart surgery, stroke care, neurosurgery, cancer treatment and much more. The range of Mercyhealth's specialties and the skills of our doctors, nurses and clinical staff are truly extraordinary.