Job Description
GENERAL SUMMARY:
Responsible for managing the insurance verification processes for the company within an assigned pod. Collects patient information data and documentation for rapid authorization of payment from the insured’s health insurance plans.
PRIMARY DUTIES & RESPONSIBILITIES:
•Contacts potential customers (by phone, email, and/or fax) as they enter the company sales pipeline as qualified leads.
•Ensures all paperwork is complete and expected order fulfillment dates are communicated.
•Manages the relationship with each customer by administering certain aspects of the reimbursement process by:
-Verifying insurance benefits to determine cost share amounts for prospective customer responsibility
-Collection of all required documentation.
-Coordinating shipments of products to customers.
•Works with Reimbursement Dept. to ensure data provided meets invoicing requirements.
•Works as part of the support team, including members of the Field Sales team, to ensure proactive communication of prospective customer’s order status.
•Provides feedback and makes suggestions to improve departmental processes.
•Delivers superior front-line customer support by pursuing the company’s Customer Support Excellence initiatives.
•Documents all interactions and calls into the customer relationship management (CRM) system in accordance with QA/RA and HIPAA guidelines.
•Achieves assigned goals as established by the Customer Sales Support Manager.
•Establishes and maintains accurate, complete and up-to-date records in CRM system. Conforms to a work plan that will achieve individual and department goals.
•Manages calls to maximize time and effort on the job to achieve daily metrics.
•Notifies pod leader of any deficits in systems for insurance verification.
•Confirms completion of required training plan before assuming job responsibilities.
•Ensures work is performed in compliance with company policies including Privacy/HIPAA and other regulatory, legal, and safety requirements.
•Additional duties as assigned by management.
REQUIRED QUALIFICATIONS:
•Ability to converse in insurance language routinely utilized by the health insurance industry.
•Knowledge of individual health plan insurances’ DME practices.
•Knowledge of diabetes a plus.
•Ability to read and follow procedures and flow diagrams.
•Demonstrated ability to effectively communicate over the phone with customers to resolve issues and answer questions according to department protocols and requirements.
•Able to effectively convey information related to work product in one on one conversation or in a group.
•Able to work effectively in a team environment.
•Able to alter behavior and opinions in light of new information.
•Computer competency including MS office, internet and navigation of customer relationship
management (CRM) systems.
•Familiarity with gathering data for reporting metrics is a plus.
•Bilingual English/Spanish a plus.
•Bachelor’s degree or equivalent combination of education and applicable job experience.
•1 year recent experience interfacing with patients in a sales support role.
•Experience documenting calls by typing on a keyboard while speaking to a customer on the phone.