Patient Services Lead & Peer Mentor (Rep II)

externallincarecareers; Berthoud (CO); On-site; USD 2,088,000 - 3,168,000; Full time

Job summary

externallincarecareers is seeking a Patient Service representative to accurately process patient orders and communicate clearly with all stakeholders. The role requires proficiency in customer service and knowledge of billing workflows, insurance verification, and Medicare guidelines as applicable to rehab equipment and services.

You will respond to telephone inquiries, assist patients with equipment choices, and ensure documentation supports reimbursement while maintaining ACHC requirements.

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 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

Skills

Customer service

Communication

Problem solving

Microsoft Word

Microsoft Excel

Typing

Education

High school diploma or GED

Tools

Billing system

Concern Tracker

Job description

externallincarecareers is seeking a Patient Service representative to accurately process patient orders and communicate clearly with all stakeholders. The role requires proficiency in customer service and knowledge of billing workflows, insurance verification, and Medicare guidelines as applicable to rehab equipment and services.

You will respond to telephone inquiries, assist patients with equipment choices, and ensure documentation supports reimbursement while maintaining ACHC requirements.