Customer Service Specialist

Job Description:

• Learn and maintain knowledge of current products and services offered by AdaptHealth
• Answer inbound calls, outbound calls, and emails in a timely manner
• Document call information according to standard operating procedures
• Answer questions about products, services, retail stores, and general service-line information
• Process orders, route calls, and follow up on customer calls
• Review, process, verify, and submit documentation and orders
• Complete insurance verification for eligibility, coverage, co-insurance, and deductibles
• Obtain pre-authorization when required and submit physician orders to insurance carriers
• Navigate multiple online EMR systems to obtain documentation
• Enter and review authorizations and expiration dates in the EMR system
• Communicate insurance trends to Customer Service and Management
• Verify insurance carriers in the company database and request additions when needed
• Contact patients when documentation does not meet payer guidelines and facilitate the referral process
• Meet quality assurance requirements and key performance metrics
• Resolve customer complaints and problems
• Use company-provided tools, including authorization and insurance guidelines, fee schedules, NPI, PECOS, and how-to documents

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
• Excellent customer service skills
• Analytical and problem-solving skills with attention to detail
• Decision-making ability
• Excellent verbal and written communication skills
• Ability to prioritize and manage multiple tasks
• Proficient computer skills and knowledge of Microsoft Office
• Ability to learn new technologies and understand data flow and system interaction
• General knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation requirements preferred
• Ability to work independently and as part of a group
• Ability to adapt and be flexible in a rapidly changing environment
• Compassion, empathy, accountability, proactivity, initiative, and effective teamwork