Job Description

Responsibilities:

• Submit a high volume of complete and verified Authorization Packets working from multiple task and priority lists.
• Manage Payor Portal Authorization updates and communicate these updates to team members.
• Update Patient Records appropriately based on Authorization responses.
  Update Salesforce and Brightree appropriately based on Authorization responses to direct actions to team members.
• Complete tasks and Authorization requests promptly and within allowable timelines.
• Scanning of mailed responses from Payors into Brightree and Salesforce systems and communicating responses to team members.

Payor Communication

• Place calls to DOL Medical Benefits Examiners to determine the reasoning behind Authorization processing decisions.
• Receive calls from DOL Medical Benefits Examiners regarding questions for submitted Authorization Requests.
• Communicate effectively and professionally with Payor representatives to ensure appropriate processing of Authorization Requests.


Compliance and Communication

• Communicate with patients/care team members/DOL via inbound and outbound phone calls.
• Act as a liaison between patients, Home Health teams, clinicians, and payers to ensure seamless communication and service delivery.
• Assist GivingHME as a whole by performing additional duties and responsibilities as necessary to provide the best care possible for patients.

Qualifications:

• High school diploma or GED required; Associate’s or Bachelor’s degree in a healthcare-related field preferred.
• Minimum 3 years of experience in a DME business environment, healthcare administration, preferred.
• Familiarity with DOL, DEEOIC, and private insurance billing processes is a plus.
• Deep and instinctual understanding of Durable Medical Equipment and Home Medical Equipment. Its use, functions, and care.
• Excellent communication and customer service skills.
• Strong and kind phone presence.
• Detail-oriented with strong organizational and time management abilities.
• Brightree Experience.
• Salesforce experience.
• Strong time management skills.

Requirements:

Office-based, on-site role.
May require standing, sitting, or lifting equipment up to 50 pounds.
Must be able to work collaboratively in a fast-paced, compliance-focused healthcare environment.