Customer Service Rep III - PHC

Lincare; Tucson (AZ); On-site; USD 36,000 - 54,000; Full time

Job summary

Lincare is seeking a peer mentor in Patient Services to model professional behavior, process patient orders accurately and timely, and communicate clearly with patients and referral sources. You will ensure orders are compliant, ordered items are correct, and documentation is completion-ready for reimbursement.

The role requires knowledge of ACHC, Medicare guidelines, and payer requirements, while providing support across the department and coaching colleagues as needed.

Qualifications

• Process patient orders accurately and thoroughly in a time-sensitive manner.
• Provide clear and timely communication to all stakeholders.
• Deliver excellent customer service within the department.

Responsibilities

• Respond to telephone inquiries and orders from patients and referral sources.
• Assist walk-in patients with equipment, supplies, and services as needed.
• Record concerns in Concern Tracker and determine resolution.
• Complete electronic intake in billing system; verify insurance and review documentation.
• Inform patients of payment requirements, collect payments, and guide delivery instructions.
• Comply with ACHC requirements and Medicare guidelines as applicable.
• Understand payer and utilization guidelines; process insurance authorizations as needed.
• Build positive relationships with referral sources and internal/external customers.
• Contribute to quality assurance by confirming order accuracy prior to submission for reimbursement.
• Understand CPAP compliance guidelines and rehab equipment coverage where required.
• Meet or exceed a QA score of 85% and provide coverage in all department areas.
• Serve as a peer mentor to staff and lead by example in business acumen and knowledge.

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