Customer Service Specialist

Adapthealth - Knoxville, TN

Full-time - Entry Level

Knoxville, TN

Merchant Wholesalers, Durable Goods

About the position

The Customer Service Specialist at AdaptHealth plays a crucial role in ensuring that patients receive the necessary home medical equipment and services. This position involves managing inbound and outbound calls, processing orders, and verifying insurance information to facilitate patient care. The specialist is expected to educate patients about their financial responsibilities and maintain a high level of customer service in a fast-paced environment.

Responsibilities

• Develop and maintain working knowledge of current products and services offered by the company
• Answer all calls and emails in a timely manner, in adherence to their goals
• Document all call information according to standard operating procedures
• Answer questions about products and services, retail stores, general service line information and other information as necessary based on customer call needs
• Process orders, route calls to appropriate resource, and follow up on customer calls where necessary
• Review all required documentation to ensure accuracy
• Accurately process, verify, and/or submit documentation and orders
• Complete insurance verification to determine patient's eligibility, coverage, co-insurances, and deductibles
• Obtain pre-authorization if required by an insurance carrier and process physician orders to insurance carriers for approval and authorization when required
• Navigate through multiple online EMR systems to obtain applicable documentation
• Enter and review all pertinent information in EMR system including authorizations and expiration dates
• Communicate with Customer Service and Management on an ongoing basis regarding any noticed trends with insurance companies
• Verify insurance carriers are listed in the company's database system, if not request the new carrier is entered
• Contact patient when documentation received does not meet payer guidelines to provide updates and offer additional options to facilitate the referral process
• Meet quality assurance requirements and other key performance metrics
• Facilitate resolution on customer complaints and problem solving
• Pay attention to detail and demonstrate great organizational skills
• Actively listen to patients and handle stressful situations with compassion and empathy
• Utilize company provided tools to maintain quality.

Requirements

• 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 environment.

Nice-to-haves

• General knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation requirements preferred.