Customer Service Specialist

Adapthealth - Riverside, CA

Full-time - Entry Level

Riverside, CA

Merchant Wholesalers, Durable Goods

About the position

The Customer Service Specialist at AdaptHealth plays a crucial role in ensuring successful service delivery to patients by managing the front-end processes of home medical equipment services. This position involves handling inbound and outbound calls in a fast-paced environment, verifying patient information, processing orders, and educating patients about their financial responsibilities. The specialist is expected to maintain a high level of customer service while navigating various systems and documentation requirements.

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.
• Proficient computer skills and knowledge of Microsoft Office
• Solid ability to learn new technologies and possess the technical aptitude required to understand flow of data through systems as well as system interaction.