Customer Documentation Representative I

Tracking Code 1568-853 Job DescriptionPOSITION SUMMARY: The incumbent in this entry level position is instrumental in ensuring the orders for products and services that we provide our patients include complete and accurate information ensuring we can bill and be reimbursed for the cost of products and services. Our patients pay for our products and services directly, or by using their insurance and/or other payors (e.g. Medicare). The team member is required to learn and become very familiar with a variety of guidelines and regulations. It is also important that they exhibit compassion and have a sense of urgency in solving problems with a customer service focus. They will interact with patients, caregivers, medical professionals, insurance companies and internal departments to provide support for the organization s Sales&Field Operations. The success metrics of this position are based on productivity, performance, as well as the quality and accuracy of work processed. Maintaining confidentiality and all other aspects of HIPAA compliance are essential in this job due to the sensitive health care information involved in servicing our customers. PRIMARY RESPONSIBILITIES: Confirm patient information from new orders as they arrive in queue; prioritize incoming items according to product type and level of urgency. Input new order and patient information into Brightree system. Answer telephones and ensure appropriate action related to inquiry. Receive and distribute faxes to appropriate party. Access insurance/payer websites to research guidelines and determine coverage. Utilize Electronic Medical Records (EMR) applications to scan, access, catalog and review documents. Access knowledge applications and reference tools to research information. Represent assigned center location in responding to a variety of concerns; maintain familiarity with site needs and state-specific documents. Escalate urgent or unique concerns to immediate supervisor and provide support where appropriate. Accurately reflect status in telephony system. Multi-task and complete high volumes of work with an extremely strong attention to detail is essential Respond to email or notifications to process with new orders. Assists with and responds to internal and external customer requests and inquiries, researching and resolving in a professional manner. Demonstrates and ensures a commitment to quality in all actions and decisions in accordance with Company standards. Review orders for accuracy; access internal systems to verify information and ensure documents are available in EMR application. Contact patient/caregiver to obtain verbal confirmation of order and inform them of benefits coverage and an amount owed; cancel processing at patient request. Submit CPAP orders for payment. Confirm payment type and notate account in system; complete appropriate forms for credit card transactions. Inform patient that center staff will contact them for delivery and setup; create system ticket. Review prescription and account information and validate documents in EMR. Assist walk-in patients and customers as needed. Accept incoming shipments and order supplies as needed. KNOWLEDGE, SKILLS AND ABILITIES: Ability to exhibit compassion for patients while demonstrating a sense of urgency in solving problems with a customer service focus. Ability to perform repetitive work with frequent interruptions without losing patience or focus. Effectively communicate with internal and external parties, including patients and insurance companies, via email, fax and phone. Must be organized and pay attention to details while ensuring a high quality work product. Ability to be an independent problem solver within both the regulatory and operating guidelines while applying common sense. Must have the ability to manage multiple tasks and prioritize. Knows when to escalate an issue or question to a more experienced team member or supervisor. Ability to be able to learn and apply complex requirements by reading. Ability to be a team player that values and practices helping others. Proficiency with Microsoft Office applications and data entry skills are required. Excellent written and verbal communication skills and the ability to interact effectively by phone and email. MINIMUM QUALIFICATIONS: High school diploma or GED A minimum of one (1) year of customer service or healthcare industry experience. Working knowledge of Medicare, Medicaid and private insurance is highly desired. Priority may be given to candidates with bi-lingual (English/Spanish) fluency in certain market areas. PHYSICAL REQUIREMENTS: Approximately 15% of the workday will be spent walking/standing and the remainder, sitting. Keyboarding is regularly performed 75% of the total time. Up to 30% of the day may be spent interacting by phone. Pacific Pulmonary Services is an Equal Opportunity Employer Any offer of employment is contingent upon the results of a pre-employment drug test and background check. The above job definition information has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of employees assigned to this job. Job duties and responsibilities are subject to change based on changing business needs and conditions. IND123 Job Location Oklahoma City, Oklahoma, United States Position Type Full-Time/Regular