Customer Service Rep III - PHC

Lincare Holdings; Berthoud (CO); On-site; USD 42,000 - 52,000; Full time

Job summary

Lincare Holdings is seeking a dedicated Patient Service professional in Colorado to accurately and promptly process patient orders, respond to inquiries from patients and referral sources, and ensure timely communication with all stakeholders.

The role requires handling insurance verification, billing intake, and adherence to ACHC and Medicare guidelines, while maintaining high quality assurance and customer service standards across the department.

Qualifications

• High School diploma or GED required.
• Prefer 2 years of home health, customer service, call center, or insurance experience.
• Strong organization, communication, analytical, and problem-solving skills required.
• Must have basic understanding of Microsoft Word, Excel, and excellent typing skills.

Responsibilities

• Respond to telephone inquiries and orders from patients and referral sources.
• May assist walk-in patients with the selection of equipment, supplies, and services.
• Determine resolution of patient and referral inquiries, questions, or concerns.
• Complete electronic intake in billing system, verify insurance, and review documentation for accuracy to qualify patient for services.
• Contact patients to inform them of any payment requirements, collect payment, and arrange delivery instructions.
• Understand ACHC requirements and Medicare guidelines as applicable.
• May process insurance authorization and follow up on requests as needed.
• Establish positive relationships with referral sources and internal/external customers.
• Set the working example for other Patient Service employees in business acumen and knowledge.
• Complete departmental projects and peer coaching as assigned.

Skills

Customer service

Communication

Organization

Analytical

Problem-solving

Typing

Education

High School diploma or GED

Tools

Microsoft Word

Microsoft Excel

Typing

Job description

This employee is a peer mentor for the department, responsible for setting a professional example in business acumen. This employee must accurately, thoroughly, and in a time-sensitive manner process patient orders and provide clear and timely communication to all stakeholders.

• Proficient in and performs all Customer Service I and II core responsibilities
• Respond to telephone inquiries and orders from patients and referral sources
• May assist walk-in patients with the selection of equipment, supplies, and services
• Determine resolution of patient and referral inquiries, questions, or concerns
  • Identify concerns and ensure they are recorded in Concern Tracker system when appropriate
• Complete electronic intake process in billing system, perform verification of insurance, and review all documentation for accuracy to qualify patient for services
• Contact patients to inform them of any patient payment requirements, collect payment, and determine best delivery method to provide instructions for receiving delivery
• Understand and abide by Accreditation Commission for Health Care (ACHC) requirements
• May need to understand and interpret Medicare guidelines and qualifying documentation
• Thoroughly understand payer and utilization guidelines
• May process insurance authorization and follow up on requests as needed
• Establish positive relationships with referral sources and build rapport with internal and external customers
• May be required to perform quality assurance process, confirming accuracy of orders prior to submission for reimbursement
• Understand C-PAP compliance guidelines as required by assignment or has obtained knowledge of rehab specialty equipment and coverage criteria
• Consistently meet Quality Assurance score of 85% or above
• Provide coverage in all areas of assigned department as needed
• Set the working example for other Patient Service employees in business acumen and knowledge
• Complete departmental projects as assigned
• Peer to peer coaching as needed

Education/Experience

• High School diploma or GED equivalency required
• Prefer 2 years of home health, customer service, call center, or insurance experience
• Strong organization, communication, analytical, and problem-solving skills required
• must have basic understanding of Microsoft Word, Excel, and excellent typing skills

Physical Demands

The employee must occasionally lift and/or move up to 10 pounds.