Insurance Intake Specialist/ Medical Biller

» Insurance Intake Specialist/ Medical Biller
Call Center & Customer Service
in Orlando
, FL
Reference: 19-03003

Responsibilities:

  • Responsible for performing the new patient intake procedures
  • Responsible for identifying appropriate candidates for home medical equipment
  • Evaluates patients referred for treatment to determine appropriateness for admission
  • Responsible for obtaining initial and ongoing insurance/managed care benefits for insurance providers
  • Familiar with standard concepts, practices, and procedures within the home medical equipment field
  • Relies on limited experience and judgment to plan and accomplish goals

Patient Care Coordination:

  • Answers phones and takes care of patients questions and concerns
  • Provides customer service
  • Schedules equipment set-ups and pick-ups
  • Gets all required information (i.e. verify address, directions, payment information, etc) to set up a patient with equipment
  • Follows up with total knee replacement patients and/or post- op patients to find out discharge date from hospital/status
  • Handles all incoming pop-up orders accordingly

Billing:

  • Requests authorization for any type of insurance, including medicare Replacement HMOs, Commercial insurances, etc.
  • Initiates referrals process with Medicare HMO plans
  • Assures that insurance gets verified electronically or via phone
  • Ensures that diagnosis and HCPS and units are correct and match item provided to patient, as well as authorization
  • Familiar with billing process
  • Initiates appeals process for denied authorizations
  • Initiates Work Comp authorizations, negotiates pricing with adjusters and third parties

Administrative Duties:

  • Maintains tracking boards
  • Creates cards for all orders
  • Tracks progression from Probability→To Be

Scheduled:

  • Creates schedule for Patient Care Representatives
  • Records meeting minutes
  • Tracks overdue script list
  • Distributes faxes
  • Enters/Tracks orders
  • In Cortex
  • In Busy Cal
  • In the Patient Tracking Log
  • Creates files for all orders
  • Makes sure all necessary information is in the file
  • Requests clinical notes from doctor’s offices
  • Assists Office Manager and Billing Coordinator

Insurance Verification/Payment Arrangements:

  • Verifies status of patients insurance, auto or worker’s compensation coverage
  • Offers patients private pay rate for non-covered equipment and non-covered rental extensions

Coordinate Patient Care Representatives Schedule:

  • Prints a daily schedule listing all set-ups and pick-ups
  • Includes set-up tickets with maps and directions
  • Includes pick-up tickets with maps and directions
  • Includes any equipment exchanges
  • Supplies accurate directions and maps to locate patients home
  • Coordinates weekend schedule
  • Lists all scheduled set-ups
  • Lists all possible set-ups