Rep , Customer Care

PRI IV Coordinator II

Flex schedule available starting 8A to 9:30A EST and some overtime and Saturdays, as needed 100% Remote - must have high speed WiFi and quiet place to set up home office Pay Rate $13 - $15 DOE Max Bill Rate $19.05 Max OT Bill Rate $26.55

POSITION PURPOSE

To verify new patient insurance coverage and to re-verify existing patient insurance coverage for medical supply eligibility and billing purposes

PRIMARY DUTIES AND RESPONSIBILITIES

• Verification and documentation of new patient insurance coverage and coordinating costs for supplies in order to communicate to the patient and billing what the patient order cost will be
• Re-verification of existing patient insurance coverage to ensure that repeat order cost and eligibility is communicated to the patient and the billing department
• Contact insurance carriers to request any prior authorizations as needed for patients that must seek prior approval before obtaining medical supplies
• Special verification projects for newly contracted insurance plans and audit of any patients that may be impacted
• Verification of insurance coverage through HIPAA and regulatory complaint out bound phone calls or via the providers online portal
• Communication internally with Sales operations or Medical Billing operations of insurance eligibility for each new and existing patient in order to complete the sale or obtain further medical documentation
• Communication externally with patients to explain information received relative to their insurance benefit and how it relates to their medical supply purchase
• Develops and maintains knowledge in medical terminology, billing and insurance guidelines
• Ability to identify and professionally resolve insurance verification related issues
• Track daily production and submit daily log to direct supervisor

ANCILLARY DUTIES AND RESPONSIBILITIES

• Maintain a positive work atmosphere that embodies Liberator's philosophy
  - Professional excellence, teamwork and integrity.
• Performs other duties and tasks as assigned

REPORTING RELATIONSHIP RESPONSIBILITIES

No supervisory responsibilities

MINIMUM REQUIREMENTS OR QUALIFICATIONS

a. Education/

Experience:

High School Diploma or general education degree (GED); one to two years related experience and/or training; or equivalent combination of education and experience.

b.

Skills:

• Language:
  Ability to read, analyze, and interpret medical supply publications, technical procedures, and/or training tools. Ability to write internal and external business correspondence. Ability to effectively present information and respond to questions from management, team members, and/or customers.
• Math:
  Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, and percentages. Ability to apply intermediate math skills.
• Reasoning:
  Ability to solve practical problems and deal with a variety of variables. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. Advanced analytical reasoning to include ability to forecast exponentials within work flow processes and reason against outside factors.
• Computer:
  Knowledge of Microsoft Office Applications, Access or other database software.
• Telecommunications: ability to utilize or knowledge of call center telecommunications software

c. Licensure or Certifications required:
No certifications required

d. Production/Quality Metrics:
Demonstrate ability to produce one (1) completed insurance verification every 9-11 minutes on average, with an error rate of 3.5% or less each calendar quarter. Production and quality standards are at the sole discretion of management and are subject to revision at any time and without prior written notice.

WORK REQUIREMENTS

Ability to work some evening shifts, weekends, and overtime as needed

PHYSICAL DEMANDS

While performing the duties of this job, the employee is frequently required to walk, sit; use hands to finger, handle, or feel and talk or hear. The employee is occasionally required to stand. The employee must occasionally lift and/or move up to 10 lbs.

WORK ENVIRONMENT

While performing the duties of this position, the employee performs tasks in a temperature controlled office environment under normal office conditions. The noise level in the work environment is usually moderate. The work environment involves minimal exposure to hazards or physical risks, which require following basic safety precautions.