- Examine documents to verify required compliance, completeness, and accuracy of data.
- Confer with document originator and approvers to resolve identified discrepancies.
- Contact insurance companies to confirm insurance coverage and eligibility of products.
- Obtain prior authorization and/or referrals.
- Appropriately update customer database when obtaining documents and pre-authorizations.
- Appropriately update document databases, and corresponding files.
- Generate communication to the appropriate personnel on new and revised documents including Pre-authorization requests.
- Regularly communicate with Health Care Providers, Commercial and Government Payors, and Sales Managers.
- Achieve defined service level agreements.
- Communicate Payor requirements as they are discovered.
- Adheres to all HIPAA guidelines/regulations.
- High School Diploma or equivalent work experience
- 2+ years of work experience
- Basic understanding of payor guidelines
- Analytical skills required, attention to detail, and organized
- Basic Microsoft skills.
- Ability to work well in a team environment
- Previous DME experience
- Variety of Medical, Dental and Vision Insurance Plans
- 401k Plan with Company Match
- PTO and Paid Holidays
- EAP
- Employee Discounts
- The Company's health and welfare benefits include medical, prescription, dental, vision, spending/savings accounts, disability, statutory leaves/disability programs, accident, life, wellbeing, and voluntary benefit programs.
- The Company's 401(k) Retirement Savings Plan includes: vesting and eligible participants "safe harbor" matching contributions.
- The Company's paid time off benefits include: 8 paid holidays and paid vacation based on length of service and exempt/non-exempt status.
Referral Specialist, Trevose PA - Feasterville-Trevose, United States - Hollister
1 month ago
Description
ABC Home Medical Supply, Inc is one of the nation's leading urological supply providers and serves as a one-stop shop with a comprehensive line of medical supplies and service that includes: Urological, Incontinence, Wound Care, and Ostomy. ABC Medical is part of the JDS, Inc family of businesses. Our service companies possess the knowledge and expertise to deliver first-class products and personalized home healthcare services.
Location: Trevose
Department: Operations
ABC Medical
ABC Medical is one of the nation's leading urological supply providers and serves as a one-stop shop with a comprehensive line of medical supplies and services that includes: Urological, Incontinence, Wound Care, and Ostomy. ABC Medical is part of the JDS, Inc family of businesses. Our service companies possess the knowledge and expertise to deliver first-class products and personalized home healthcare services.
Trevose, PA – onsite Monday-Friday; Hours: 8:30am-5pm PST
Responsibilities:
The Referral Specialist is responsible for verifying, obtaining, reviewing, and accurately determining that all medical documentation received from physicians or referral sources meets all local coverage determinations and regulatory requirements. The Referral Specialist is responsible for the Pre-authorization functionality.
Minimum Qualifications:
Preferred Qualifications:
Here's what we have to offer:
Pay Transparency Statement:
The anticipated base pay range for this position is $19 - $22 per hour. The actual salary varies based on applicant's location, education, experience, skills, abilities, and other legitimate business factors. The Company also provides a unique Benefit of Employee Share Ownership Program (BESOP) program.
Job Req ID: 32990