Cpap Specialist

CPAP Specialist Location Coon Rapids, MN : Position Summary: The PAP Specialist has a broad range of responsibilities including accurate and timely data entry, understanding, and selecting inventory and services in key databases, communicating with referral sources, and appropriately utilizing technology to notate patient information/communication. As needed responsible for ensuring customers receive PAP equipment by customer preferred point of service by scheduling appointments and proper instruction on how to best use the equipment. Explains customers financial responsibility and ensure payment. PAP Specialists are responsible for preparing and submitting audit paperwork for Medicare and other insurance claims to ensure continued compliance with healthcare guidelines. Responsible for monitoring, communicating, and managing all clients on Positive Airway Pressure devices. Responsible for encouraging client compliance with PAP equipment and program.
Essential Functions and Job Responsibilities: Resupply
Research and report any changes to the AdaptHealth process per Medicare and other healthcare guidelines. Research and respond to questions from supervisors and other employees regarding specific Medicare and other healthcare issues on a case-by-case basis. Helps with order processes as needed by other AdaptHealth departments. Ensure the audit tracking is updated and changed per any process changes within AdaptHealth or per any criteria changes with Medicare/healthcare guidelines. Any other items as needed to assist the manager with managing the internal quality and compliance aspects per Medicare or other healthcare agency guidelines. Collect and submit documentation as needed for each audit received. Ensure all AdaptHealth documents for patients are updated and formatted per Medicare and other healthcare criteria. Examples of the documents include the Welcome Kit, Prescription templates, and Equipment Set-up documents. Review prescriptions and other paperwork as needed from other HME Partners to ensure Medicare compliance. Navigate system for review of claim documentation, insurance eligibility, and order details. Navigate billing site, such as Brightree and Athena, to review paid and denied claims. Research claim information using the Medicare Portals. Review and analyze monthly orders to ensure all processes and quality aspects are monitored to meet Medicare and AdaptHealth guidelines. Customer Service
Responsible for both inbound and outbound calls • Insurance verification and explanation of coverage details to the customer Ensuring best method of providing equipment is met • Explain compliance requirements to the customer to ensure they utilize the machine to their Insurance companies' standards Collects patient financial responsibility prior to processing new supply tickets Responsible for sending letters to patients when contact cannot be made • Consistently answers emails concerning patients' needs in a timely manner Follows through on emails/phone calls until patient is taken care of Demonstrates patient concern by consistently asking every patient how he/she is doing when speaking to him/her Makes recommendations for company equipment that will improve quality of care as appropriate Job Title: PAP Specialist FLSA Classification: Non-Exempt Department: PAP Department Rev Date: 11/20 Reports To: Department Leader Approved by: Human Resources Successfully troubleshoots equipment problems over the phone Verifies or obtains alternate contact information Verifies delivery address, delivery instructions and telephone number for all orders Reviews documentation to make sure it is valid prior to processing an order Understands and utilizes the most cost-effective delivery method for items ordered Documents accounts with any delivery expectations and requests Uses standard note formats and notates contact with patient or family Complete all orders received via CMB, email, fax, or phone in a timely manner Through daily work activities identifies trends, either system or process driven, that can be changed or modified to improve efficiency and create cost savings Supports the achievement of departmental and organizational goals by assisting co-workers in completion of call schedules and other assigned tasks Is actively involved in team activities, evidenced by participation, mentoring, and training with co-workers Assists in the development and maintenance of reference materials for use by staff and facilitates the sharing of information Adherence Team Responsible for monitoring patient's on PAP devices daily within compliance software. Responsible for daily follow up with patients to address issues with compliance or troubleshooting of mask and equipment. Responsible for communicating with local branches in a timely manner for follow ups needed for patient's by respiratory therapist. Responsible for follow up with patients to ensure follow up appointments with physicians are scheduled and met. Responsible for follow ups with physicians' offices to obtain follow up notes to submit into billing software. Responsible for proper documentation of all patient, physician, and branch interactions within the compliance software. Responsible for coordination of patient resupply issues with the resupply team. Participates in on call rotation to answer any patient questions after hours. New Starts Team Enters referrals within allotted timeframe as established; meeting productivity and quality standards as established. Communicates with referral sources, physician, or associated staff to ensure documentation is routed to appropriate physician for signature/completion. Accurately enters referrals into appropriate system based on the type of referral obtained. Works with local branch leadership to ensure appropriate inventory/services are provided. Assists with other regional team functions, as necessary. Communicates with patients their financial responsibility, collects payment and documents in patient record accordingly. Follows company philosophies and procedures to ensure appropriate shipping method utilized for delivery of service. Answers phone calls in a timely manner and assists caller. Responsible for reviewing medical records for non-sales assisted referrals to ensure compliance standards are met prior to a service being rendered. Must be an expert at payer guidelines and reading clinical documentation to determine qualification status and compliance for all equipment and services. Responsible for working with community referral sources to obtain compliant documentation in a timely manner to facilitate the referral process. Responsible for contacting patient when documentation received does not meet payer guidelines to provide updates and offer additional options to facilitate the referral process. Works with sales team to obtain necessary documentation to facilitate referral process as well as support referral source relationships. Must be able to navigate through multiple online EMR systems to obtain applicable documentation. Works with verification team to ensure all needs are met for both teams to provide accurate information to the patient and ensure payments. All PAP Specialist responsibilities: Develop and maintain working knowledge of current HME products and services offered by the company and all applicable insurance guidelines respecting eligibility for coverage and reimbursement. Is actively involved in team activities, evidenced by participation, mentoring, and training with co-workers Assists in the development and maintenance of reference materials for use by staff and facilitates the sharing of information Develops relationships with branches, other teams to accomplish goals Participates in monthly team meetings and trainings Responsible for entering data in an accurate manner, into database including although not limited to payer, authorization requirements, coverage limitations and status of any requalification Collaborates with physician offices, AdaptHealth sales and support staff to ensure timely receipt of documentation as well as educating, as necessary. Identify trends and providing feedback and education to internal and external customers on compliant documentation requirements for services provided. Assume on-call responsibilities during non-business hours in accordance with company policy Maintain patient confidentiality and function within the guidelines of HIPAA Completes assigned compliance training and other educational programs as required Maintains compliant with AdaptHealth's Compliance Program Perform other related duties as assigned 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 • Solid ability to learn new technologies and possess the technical aptitude required to understand flow of data through systems as well as system interaction Education and Experience 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 HME, Diabetic, Pharmacy, or home medical supplies environment that routinely bills insurance. Physical Demands and Work Environment: Work environment may be stressful at times, as overall office activities and work levels fluctuate • Must be able to bend, stoop, stretch, stand, and sit for extended periods of time Subject to long periods of sitting and exposure to computer screen Ability to perform repetitive motions of wrists, hands, and/or fingers due to extensive computer use • Must be able to lift 5 to 10 pounds periodically as needed. May be exposed to angry or irate customers or patients. This position if primarily performed within an office building. Excellent ability to effectively communicate both verbally and written with customers with the ability to demonstrate empathy, compassion, courtesy, and respect for privacy. Mental alertness to perform the essential functions of position Job Type: Full-time
Salary: $39,000.00 - $47,000.00 per year
Benefits:
401(k)401(k) matching Dental insurance Health insurance Paid time off Vision insurance Schedule:
Monday to Friday Ability to commute/relocate:
Edina, MN: Reliably commute or planning to relocate before starting work (Required) Experience:
Customer service: 2 years (Preferred) Medical terminology: 2 years (Preferred) Insurance verification: 2 years (Preferred) Work Location: In person ntake Specialist St. Paul, MN
Posted on Career Page AdaptHealth LLC
Description AdaptHealth Opportunity - Apply Today! At AdaptHealth we offer full-service home medical equipment products and services to empower patients to live their best lives - out of the hospital and in their homes. We are actively recruiting in your area. If you are passionate about making a profound impact on the quality of patients' lives, please click to apply, we would love to hear from you.
Intake Specialist The Intake Specialist has a broad range of responsibilities including accurate and timely data entry, understanding, and selecting inventory and services in key databases, communicating with referral sources, and appropriately utilizing technology to notate patient information/communication. Intake Specialist's schedules can vary based on the need of the branch.
Job Duties: Enters referrals within allotted timeframe as established; meeting productivity and quality standards as established. Communicates with referral sources, physician, or associated staff to ensure documentation is routed to appropriate physician for signature/completion. Accurately enters referrals into appropriate system based on the type of referral obtained. Works with local branch leadership to ensure appropriate inventory/services are provided. Assists with other regional team functions, as necessary. For non-Medicaid patients communicates with patients their financial responsibility, collects payment and documents in patient record accordingly. Follows company philosophies and procedures to ensure appropriate shipping method utilized for delivery of service. Answers phone calls in a timely manner and assists caller. For non-Medicaid patients communicates with patients Responsible for reviewing medical records for non-sales assisted referrals to ensure compliance standards are met prior to a service being rendered. Must be an expert at payer guidelines and reading clinical documentation to determine qualification status and compliance for all equipment and services. Responsible for working with community referral sources to obtain compliant documentation in a timely manner to facilitate the referral process. Responsible for contacting patient when documentation received does not meet payer guidelines to provide updates and offer additional options to facilitate the referral process. Works with sales team to obtain necessary documentation to facilitate referral process as well as support referral source relationships. Must be able to navigate through multiple online EMR systems to obtain applicable documentation. Works with verification team to ensure all needs are met for both teams to provide accurate information to the patient and ensure payments. Competency, Skills and Abilities: Ability to appropriately interact with patients, referral sources and staff. Decision Making Analytical and problem-solving skills with attention to detail Strong verbal and written communication Excellent customer service and telephone service skills Proficient computer skills and knowledge of Microsoft Office Ability to prioritize and manage multiple tasks 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 One (1) year work related in health care administrative, financial, or insurance customer services, claims, billing, call center or management regardless of industry is required. Exact job experience is considered any of the above tasks in a Medicare certified HME, IV or HH 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.
Job Type: Full-time
Pay: $39,000.00 - $47,000.00 per year
Benefits:
401(k)401(k) matching Dental insurance Health insurance Paid time off Vision insurance Schedule:
Monday to Friday Experience:
Customer service: 2 years (Preferred) Medical terminology: 2 years (Preferred) Insurance verification: 2 years (Preferred) Work Location: In person