Customer Service Rep, Durable Medical Equipment

Essential Duties and Responsibilities

• Manages phone calls from patients and referral sources.
• Responsible for intake of referral orders from phone calls, Epic and faxes, using departmental procedures.
• Performs insurance verification on each order to assess coverage, documentation and prior authorization needs.
• Obtains and reviews clinic notes, progress notes, orders, demographics, face-to-face and medical justification documentation from referrals to meet documentation expectations for Mercy Assisted Care per Federal, State and payer requirements.
• Maintains current knowledge of relevant documentation requirements for products provided by Mercy Assisted Care.
• Processes and submits prior authorizations for insurance approval of equipment rental or purchase.
• Responsible for entering accurate work order information, selecting appropriate supplies and/or equipment and delivery method for a seamless delivery. Maintains assigned Operator Tasks to ensure timely follow up with tasks.
• Schedules repairs for on-site repair technician.
• Reviews and obtains valid prescriptions through the Rx workflow.
• Reviews, routes and processes faxes through the fax workflow.
• Problem solves a wide range of customer issues and complaints, appropriately referring issues outside their scope of practice.
• Works with MAC purchasing department to subcontract orders from outside vendors for Mercy system patients.
• Must be able to select appropriate products given patient's medical need, life style and overall condition. Familiar with contraindication of all products and liability issues for MAC.
• Acts as liaison between Mercy Assisted Care and key internal and external customers/ referral sources.
• Responsible for maintaining and working the auto reorder program for supplies
• Maintain up-to-date, accurate information regarding equipment to meet accreditation and regulatory requirements.
• Verify patient's demographic/insurance (payer) information to ensure accurate input to billing for reimbursement.
• Monitor reports for timely renewals of prescriptions, prior authorizations, rentals and missing information.
• Responsible for absorbing and applying information provided in Customer Service Huddles, Customer Service meetings and MAC all staff meetings.

Education and Experience

• High school diploma or equivalent; or 1 year's related experience and/or training; or equivalent combination of education and experience.
• Certification and Licensure
• N/A

Skills and Abilities

N/A

Special Physical Demands

While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel; reach with hands and arms and talk or hear. Must be able to read and write in English. The employee must occasionally lift and/or move up to 10 pounds. These Special Physical Demands are considered Essential Job Functions of the position with or without accommodations.

• Level of Supervision
• N/A
• Supervises
• N/A

Pay Range

$15.00 - $27.20

Benefits

Mercyhealth offers competitive pay and a comprehensive benefits package including:

• Medical, Dental, Vision
• Life & Disability Insurance
• FSA/HSA Options
• Generous, accruing paid time off
• Paid Parental and caregiver leave
• Career advancement and educational opportunities
• Tuition and certification reimbursement
• Certification Reimbursement
• Well-being Programs
• Employee Discounts
• On-Demand Pay
• Financial Education
• Annual recognition/awards events
• Partner appreciation days
• Family entertainment/attractions discount
• Community service/improvement opportunities

Click here for more details regarding Mercyhealth Careers Benefit Information.

At Mercyhealth, we don't simply hire people, we empower employee-partners who are passionate about making lives better. As an integrated health system, we deliver exceptional, coordinated across seven hospitals, 85 primary and specialty clinics, and a team of over 7,500 professionals serving northern Illinois and southern Wisconsin.

Mercyhealth has been nationally recognized for our commitment to our people and culture, including:

• #1 in the nation on AARP's Best Employers for Workers Over 50
• One of Working Mother magazine's 100 Best Companies for Working Mothers
• A Top 50 Company and Top 10 Nonprofit for Executive Women