COMPETENCY, SKILLS AND ABILITIES:

• Decision Making
• Analytical and problem-solving skills with attention to detail
• Strong verbal and written communication
• Excellent customer service skills
• Proficient computer skills and knowledge of Microsoft Office
• Ability to prioritize and manage multiple tasks
• Reports To: Department Manager Approved by: Human Resources
• Solid ability to learn new technologies and possess the technical aptitude required to understand flow of data through systems as well as system interaction
  Requirements:

MINIMUM JOB QUALIFICATIONS:

• High School Diploma or equivalent
• One (1) year work related experience in health care administrative, financial, or insurance customer services, claims, billing, call center or management regardless of industry
• Senior level requires two (2) years of work-related experience and one (1) year of exact job experience
• Exact job experience is considered any of the above tasks in a Medicare certified HME, Diabetic, Pharmacy, or home medical supplies environment that routinely bills insurance.
  AdaptHealth is an equal opportunity employer and does not unlawfully discriminate against employees or applicants for employment on the basis of an individual’s race, color, religion, creed, sex, national origin, age, disability, marital status, veteran status, sexual orientation, gender identity, genetic information, or any other status protected by applicable law. This policy applies to all terms, conditions, and privileges of employment, including recruitment, hiring, placement, compensation, promotion, discipline, and termination

• Create and generate electronic forms requesting patient documents from physicians.
• Collect and manage patient eligibility documents such as prescriptions, certificates of medical necessity, letters of medical necessity and prior authorizations.
• Contact doctor offices as necessary to collect prescriptions, certificates of medical necessity, letters of medical necessity, clinical notes, and lab results.
• Contact insurance companies to collect approved prior-authorization requests.
• Escalate recurring problem accounts or physician groups or other trends to the management appropriately and in a timely manner.
• Maintain regular, predictable, consistent attendance and flexibility to meet the needs of the department.
• Understand and follow all Medicare, Medicaid, HIPAA, and Private Insurance regulations and requirements.
• Plan and organize work effectively and ensure its completion.
• Meet all productivity requirements.
• Demonstrate team behavior and promote a team-oriented environment.
• Actively participate in continuous quality improvement.
• Always represent the organization professionally.
• Serve as backup to Customer Service department for customer concerns, issues, complaints, or questions.
• Analyze documentation required for billing services and ensure compliance to payer requirements.
• Resolve pending revenue by reconciling received documentation and pending charges.
• Collaborates with physician offices, AdaptHealth sales and support staff to ensure timely receipt of documentation.
• Identify trends and providing feedback and education to internal and external customers on compliant documentation requirements for services provided.
• Requests authorization from state Medicaid programs.
• Maintains and updates physician databases to ensure accurate delivery of billing documentation and communications with physician offices.