+ Position Summary

+ Under general supervision provides service directly to HHME customers including the selection of equipment/supplies and performs clerical tasks involved in processing and maintaining routine written materials used by the department. Performs tasks required for the proper billing of equipment/supplies including meeting third party payer requirements. Independently performs equipment/supply set-ups with customers, equipment/supply maintenance, equipment/supply troubleshooting, environmental assessment, customer/caregiver education and assists with discharge planning. Ensures all actions taken in carrying out responsibilities support patient centered care.

+ Position Responsibilities

+ Unit Specific Position Responsibilities

+ Performs Intake functions

+ Secures necessary information during the admission registration process

+ Obtain, verify and maintain customer demographics and insurance information for billing purposes (i.e. admission, financial/cost, CMN, benefits and authorizations, etc…).

+ Obtains both written, verbal and telephone orders from appropriate healthcare professionals.

+ Obtain, review, verify and maintain medical documentation as required by third party payers/insurance for payment.

+ Registers the patient on both the hospital’s computer software and the department’s computer software.

+ Interviews patients to secure payments on accounts, determine if a patient may be in need of financial assistance, and to answer any billing questions.

+ Performs billing functions

+ Accurately posts charges to accounts with appropriate codes, modifiers and information.

+ Monitors recurring accounts monthly and performs necessary follow-up such as rebilling, equipment usage verification and other requirements.

+ Answer questions and resolve problems related to billing operations.

+ Reviews and prepares documents for claim filing

+ Works to resolve carrier denials for proper payment of claims including appeals and resubmission.

+ Identifies potential discrepancies in claims payment processing.

+ Handles inquires regarding claims/reports.

+ Secure payments (Cash, check, payroll deduct, etc…) and maintains daily reconciliation/balancing documents per policy.

+ Maintain current knowledge of carrier specific requirements by attending workshops and/or webinars and/or presentations, reading newsletters, reading manuals and acting as a liaison in carrier meetings.

+ Initiates and coordinates prior authorization requests to third party payers and maintains a working knowledge of third party payer guidelines. Follows up with third party payers as necessary.

+ Assists with inventory system by establishing new CDMs with required information, performing cost comparison, interacts with manufacturer representatives, adjusts inventory levels, and orders inventory.

+ Operates computer system to accurately document and retrieve information in a timely manner.

+ Specializes in one or more of the agency’s service lines, yet is responsible for having a basic knowledge of all service lines.

+ Supports and assists in role of Equipment Representative when necessary

+ Meets measures as determined and required for job productivity and performance improvement.

+ Employee is responsible for completion of communication tasks and activities in a timely manner. This would include, but is not limited to: responding to email, voicemail or telephone messages, promptly, accurately, and professionally; attending staff meetings as scheduled or viewing videotapes of those meetings; asking questions of team members and supervisor when needing clarification about various day-to-day issues or patient needs; and reviewing employee communication pieces, such as The MGMCgram, to stay aware of MGMC/HHME programs and initiatives.

+ Facilitate changes to improve processes as needed.

+ Performs patient follow up phone calls as directed by manager.

+ Interacts with patients, family, and caregivers in a friendly and professional manner on the phone, in the showroom and in the client’s home to ensure customer satisfaction.

+ Coordinates the delivery and set-up of equipment.

+ Performs other duties as requested by HHME Supervisor to facilitate the smooth and effective operations of the organization.

+ Maintains compliance with OSHA, accreditation standards and risk management guidelines.

+ Prepares and organizes work schedule to accommodate department priorities. Identifies priority conflicts when they exist and brings them to the attention of the Supervisor for resolution.

+ Qualifications, Knowledge & Experience

+ Required Qualifications (Including any licensure, certification, education):

+ Knowledge of basic spelling, punctuation, grammar and basic business math.

+ Valid driver’s license and meets MGMC’S insurance carrier requirements for coverage.

+ Mandatory Reporter training within 90 days of hire and must maintain throughout employment.

+ Organizational Requirements:

+ Maintain stroke education per regulatory requirements.

+ Preferred Qualifications:

+ RQI Responder

+ Required Knowledge, Skills & Experience:

+ Ability to demonstrate clinical competence and maintain current knowledge in caring for adolescent through geriatric patients.

+ Ability to communicate effectively both verbally and in writing.

+ Skill in effective oral and written communication in English.

+ Knowledge of basic arithmetic and application

+ Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar.

+ Active Listening skills, giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.

+ Moderate to advanced typing and/or computer keyboard skills.

+ Knowledge of human relations skills

+ Ability to establish and maintain effective working relationships with others.

+ Ability to deal tactfully with the public

+ Ability to handle confidential work with tact and discretion

+ Ability to handle complex clerical tasks and routine decisions in accordance with policy.

+ Preferred Knowledge, Skills & Experience:

+ Knowledge of medical terminology, anatomy and physiology.

+ Knowledge of medical billing practices.

+ One year of medical experience; preferably in community home health or home medical equipment.

+ Previous experience leading to exposure to general clerical routines and procedures / development of special clerical skills

+ Knowledge of general office practices and procedures.