What are the responsibilities and job description for the Sleep Intake Specialist - Insurance Verification position at VieMed?

Essential Duties and Responsibilities :

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position.
Obtains patient demographic and health insurance information; collects co-pay(s) when appropriate
Verifies and records insurance benefits, with the ability to understand and provide insurance breakdowns
Obtains prior authorization if required by payer(s)
Interacts professionally with physicians, patients, patients family and co-workers
Schedules set ups, as called into VieMed, by physicians or physician's office staff, per policy and procedure
Retrieves incoming referral(s) and logs demographic information into current patient database & billing system
Reviews medical records from referral(s) to determine if medical necessity has been met
Communicates to sales team & / or referral source(s), if referral is acceptable or what is missing to complete referral(s)
Documents in computer system the status of referral
Reports all concerns or issues directly to Resupply Supervisor
Other responsibilities and projects as assigned

Qualifications

High School Diploma or equivalent

One (1) to two (2) years working for a Durable Medical Equipment company or relevant medical office experience preferred

Basic understandings of medical insurance benefits

Skill in establishing and maintaining effective working relationships with other employees, patients, organizations, and the public

Effectively communicate with physicians, patients, insurers, colleagues and staff

Able to read and understand medical documentation effectively

Knowledge and understanding of same and similar DME equipment

Knowledge and understanding of In-network vs Out of Network, PPO, HMO

Thorough understanding and maintaining of medical insurances company's regulations and requirements to include but not limited to Medicare and Medicaid

Working knowledge of CPT, HCPCS & ICD10 codes, HCFA 1500, UB04 claim forms, HIPAA, billing and insurance regulations, medical terminology, insurance benefits.

Learns and maintains knowledge of current patient database & billing system

Up to date with health information technologies and applications

Answers telephone in a polite and professional manner. Communicates information to appropriate personnel and management in a timely manner

Establishes and maintains effective communication and good working relationships with co-workers, patients, organizations and the public

Proficient in Microsoft Office, including Outlook, Word, and Excel

Utilizes initiative, strives to maintain steady level of productivity and is self-motivated

Possible weekend work or overtime, to include working an on-call rotation schedule

Access to Protected Health Information (PHI)

This position will require the employee to handle Protected Health Information (PHI) for duties related to document and report preparation. Policies and procedures will be strictly adhered to make sure PHI is protected as required by the HIPAA Privacy Rule.

Working Conditions

This position will work in an office environment.

Equal Opportunity Employer / Protected Veterans / Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c) Learn More

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Sleep Intake Specialist - Insurance Verification

What are the responsibilities and job description for the Sleep Intake Specialist - Insurance Verification position at VieMed?

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