Customer Documentation Representative

Tracking Code 1665-853 Job DescriptionPOSITION SUMMARY: The incumbent in this working 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 be 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 CDR success metrics 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 and unconfirmed orders as they arrive in queue; prioritize incoming items according to product type and level of urgency. Review, assess and ensure a high quality of required documentation. Assist with obtaining all missing items for incomplete orders; redirect as needed. 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. Develop and maintain a strong applicable knowledge of respiratory products, services and related procedures, as well as the requirements for their assigned locations to respond accurately to customer needs. Escalate urgent or unique concerns to immediate supervisor and provide support where appropriate. 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. Accurately reflect status in telephony system. Multi-task and complete high volumes of work with an extremely strong attention to detail is essential Accept any missing/replacement insurance information via phone and update account. Process Revenue rejections and provide missing items; create exception document cases and track through resolution. Work non-billing patient reports by creating new cases in Brightree to obtain missing documents and get patients back to billing status. 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 ticket in system. Review prescription and account information and validate documents in EMR. Assist walk-in patients and customers as needed. Respond to email or notifications to proceed with submitted orders. Accept incoming shipments and order supplies as needed. Incumbents in this role may be assigned any combination of the responsibilities listed below and are required to assist their team in submitting patients paperwork for reimbursement. Other duties as assigned. KNOWLEDGE, SKILLS AND ABILITIES: Ability to perform complex 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 a team player that values and practices helping others. Proficiency with Microsoft Office applications and data entry skills are required. Must be able to learn and apply complex requirements by reading. Excellent written and verbal communication skills and the ability to interact effectively by phone and email. Ability to demonstrate a keen attention to detail in processing high volumes of work is essential. Above-average clerical and multi-tasking skills with a strong sense of urgency are a necessity. MINIMUM QUALIFICATIONS: High school diploma/GED required plus College coursework or specialized training in a business or healthcare-related discipline is preferred. In addition the position requires a minimum of two (2) yeas of customer service or healthcare industry experience. Preference may be given to candidates with medical records experience and or those that have been a CDR I and meet the overall minimum requirements stated above. 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 San Antonio, Texas, United States Position Type Full-Time/Regular