Customer Service Specialist

Craig Homecare; Cleveland (OH); On-site; USD 22,000 - 33,000; Full time

Benefits offered by this job

Competitive pay

Paid time off

Health vision dental insurance

Short & long-term disability & life

401K plan

Professional development opportunities

Tuition reimbursement

Job summary

Pediatric Home Service in Cleveland, OH is seeking a full-time Customer Service Specialist to support a fast-paced, patient-focused team. You will handle in-person, email and phone conversations, perform DME intake, verify insurance, and coordinate billing and orders to ensure timely delivery of services.

The role requires strong data-entry and multitasking abilities, with a focus on accuracy and cross-functional collaboration across departments.

Qualifications

• Associate's degree or equivalent from two-year college or technical school.
• Experience in DME intake and order processing.
• Experience with insurance verification, eligibility, benefits and prior authorizations.
• Experience obtaining physician/prescriber orders and supporting documentation.
• Familiarity with Medicare, Medicaid and commercial insurance requirements.
• Experience communicating with physician offices and insurance companies.
• Strong data-entry and documentation skills.

Responsibilities

• Stays abreast of process changes within departments and adopts them.
• Attend department meetings to understand changes and processes.
• Meet weekly with leadership to identify needs.
• Transition between customer service functions as needed.
• Performs intake of DME through EHR system or database.
• Coordinates intake processes and ensures proper documentation.
• Obtains insurance authorization information for products/services.
• Completes billing review of delivery tickets and IV delivery tickets.
• Monitors start-of-month delivery tickets to ensure timely processing.
• Assist internal customers via help desk, in person, phone or email.

Skills

DME intake

Insurance verification

Prior authorizations

Communication with physician offices

Data-entry

Multi-function/department support

Documentation skills

Education

Associate's degree (A. A.) or equivalent from two-year college or technical school

Tools

Brightree

EHR system

Job description

At PHS, we help medically complex kids live their best lives—at home, with their families. As a national leader in pediatric home care, we offer a full range of services including infusion, clinical nutrition, respiratory therapy, PPEC, private duty nursing, and DME.

Whether you're caring for patients or supporting behind the scenes, every role at PHS makes a difference. Join a mission-driven team that’s committed to putting children and families first.

• Position: Customer Service Specialist
• Location: Cleveland, Ohio
• Hours: Monday-Friday, 8a-5p
  • In Office

We are looking for a full-time Customer Service Specialist to join our customer-focused, supportive team. Our Customer Service department is a fast-paced, high-energy environment, you’ll find yourself challenged and required to use critical thinking every day through a variety of in-person, email and phone conversations. The Customer Service Specialist will perform any role in customer service in order to provide needed coverage. Job assignments are given by Customer Service leadership and may be short or long term.

Key Responsibilities: The following list of job functions is not exhaustive or absolute. These functions may change from time-to-time and other tasks and functions may be assigned at the discretion of management.

• Stays abreast of all process changes within each department in order to perform them as needed.
• Attend meetings for specific departments to ensure clear understanding of changes and processes.
• Meet weekly with leadership to identify specific needs.
• Transitions quickly from one Customer Service function to another according to need.
• Performs intake of Durable Medical Equipment (DME), through EHR system and/or the database.
• Performs duties of the Coordinator of the Day (COD) for both Admissions and Patient Services, if applicable
• Obtains supporting documentation.
• Obtains insurance authorization information as required for products and services provided by PHS.
• Verification of insurance benefits & complete data entry requirements.
• Completes ongoing patient supply orders.
• Obtains prescriber orders for products and services provided by PHS.
• Completes patient and prescriber information changes.
• Maintains all patient information on an ongoing basis.
• Enters new prescriber information into database.
• Coordinates intake process for specialized organizations.
• Addresses complaints concerning billing or service rendered, referring complaints of service failures to designated departments for investigation.
• Reads prescriber orders, customer orders, work orders and shipping orders to determine items to be moved, gathered, or distributed.
• Process and coordinates paperwork from items delivered for intake
• Prepare patient paperwork for billing.
• Creates and complete billing review of delivery tickets for Durable Medical Equipment (DME)
• Creates, confirms and completes billing review of IV Delivery Tickets, if applicable
• Monitor/review beginning of the month scheduled delivery tickets to ensure timely processing.
• Assists internal customers through the Customer Service help desk, phone calls, or face to face encounters.
• Performs call-outs.
• Processes ‘to dos’.
• Coordinates courier service with warehouse for deliveries as needed.
• Obtains insurance authorization as required for products and services provided by PHS.
• Obtains physician orders for products and services provided by PHS.
• Faxing and calling clinics to gather needed information.

Qualifications:

• Associate's degree (A. A.) or equivalent from two-year college or technical school; or six months to one year related experience and/or training; or equivalent combination of education and experience.
• Previous DME or home health experience
• Experience with Brightree or another healthcare/EHR system
• Knowledge of DME intake and order processing
• Experience with insurance verification, eligibility, benefits, and prior authorizations
• Experience obtaining physician/prescriber orders and supporting documentation
• Familiarity with Medicare, Medicaid, and commercial insurance requirements
• Experience communicating with physician offices and insurance companies
• Previous experience supporting multiple functions or departments
• Strong data-entry and documentation skills

Benefits:

• Competitive pay
• Paid time off (and paid holidays)
• Health, vision and dental insurance
• Short & long-term disability & life insurance
• 401K plan
• Professional development opportunities
• Tuition reimbursement

Pediatric Home Service is an equal opportunity employer; we are committed to affirmative action and equal employment opportunities for all regardless of protected veteran status, race, color, creed, religion, national origin, sex, sexual orientation or identity, disability, age, marital status, familial status, membership or activity in a local human rights commission, or status with regard to public assistance.

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