The Customer Service Specialists works in a fast-paced environment answering inbound calls and ... General knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation ...
The Customer Service Specialists works in a fast-paced environment answering inbound calls and ... General knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation ...
Sr. Coordinator, Patient Access (Care Coordinator)
Denver, CO · On-site
$18 - $23.75/hr
Responsible for handling inbound and outbound calls, with ability to determine needs and provide ... Clear knowledge of Medicare, Medicaid & Commercial payer policies and guidelines for coverage ...
Sr. Coordinator, Patient Access (Care Coordinator)
Denver, CO · On-site
$18 - $23.75/hr
Responsible for handling inbound and outbound calls, with ability to determine needs and provide ... Clear knowledge of Medicare, Medicaid & Commercial payer policies and guidelines for coverage ...
Contract Representative
$21 - $22/hr
Receive and make inbound and outbound telephone calls/emails from and to facilities as necessary to ... Experience/Skills * Minimum of one year experience in medical billing; knowledge of Medicare ...
Contract Representative
$21 - $22/hr
Receive and make inbound and outbound telephone calls/emails from and to facilities as necessary to ... Experience/Skills * Minimum of one year experience in medical billing; knowledge of Medicare ...
Contract Representative
Denver, CO · On-site +1
$21 - $22/hr
Receive and make inbound and outbound telephone calls/emails from and to facilities as necessary to ... Experience/Skills * Minimum of one year experience in medical billing; knowledge of Medicare ...
Contract Representative
Denver, CO · On-site +1
$21 - $22/hr
Receive and make inbound and outbound telephone calls/emails from and to facilities as necessary to ... Experience/Skills * Minimum of one year experience in medical billing; knowledge of Medicare ...
PATIENT ACCOUNTS SPECIALIST
Colorado Springs, CO · On-site
$20 - $25/hr
Additional Responsibilities: • Creates an exceptional customer experience when handling inbound ... Working knowledge of Medicare/Medicaid regulations, policies, and procedures. Strong customer ...
PATIENT ACCOUNTS SPECIALIST
Colorado Springs, CO · On-site
$20 - $25/hr
Additional Responsibilities: • Creates an exceptional customer experience when handling inbound ... Working knowledge of Medicare/Medicaid regulations, policies, and procedures. Strong customer ...
Facets QA / Test Architecture Lead
Englewood, CO · On-site
$132K - $155K/yr
Establish robust integration- and batch-oriented testing strategies for inbound and outbound Facets ... Ensure testing strategies align with healthcare regulatory requirements, including Medicare ...
Facets QA / Test Architecture Lead
Englewood, CO · On-site
$132K - $155K/yr
Establish robust integration- and batch-oriented testing strategies for inbound and outbound Facets ... Ensure testing strategies align with healthcare regulatory requirements, including Medicare ...
Senior Facets Test Architect - Healthcare Payer
Englewood, CO · On-site
$132K - $155K/yr
Establish robust integration- and batch-oriented testing strategies for inbound and outbound Facets ... Ensure testing strategies align with healthcare regulatory requirements, including Medicare ...
Senior Facets Test Architect - Healthcare Payer
Englewood, CO · On-site
$132K - $155K/yr
Establish robust integration- and batch-oriented testing strategies for inbound and outbound Facets ... Ensure testing strategies align with healthcare regulatory requirements, including Medicare ...
Sleep Coach
Denver, CO · On-site
$19 - $25/hr
Place and take (inbound/outbound) calls for new CPAP sleep patients to coach, educate and encourage ... Experience with various insurance plans (HMO, PPO, Medicare) SKILLS, KNOWLEDGE AND ABILITIES
Sleep Coach
Denver, CO · On-site
$19 - $25/hr
Place and take (inbound/outbound) calls for new CPAP sleep patients to coach, educate and encourage ... Experience with various insurance plans (HMO, PPO, Medicare) SKILLS, KNOWLEDGE AND ABILITIES
Health Insurance Sales Agent
Englewood, CO · Hybrid
$50K - $65K/yr
We are growing our team in Englewood, CO and have multiple Medicare Sales Agent openings available now. In this inbound call role, you will receive a competitive base salary, and bonuses based on ...
Health Insurance Sales Agent
Englewood, CO · Hybrid
$50K - $65K/yr
We are growing our team in Englewood, CO and have multiple Medicare Sales Agent openings available now. In this inbound call role, you will receive a competitive base salary, and bonuses based on ...
Health Insurance Sales Agent
Colorado Springs, CO · Hybrid
$50K - $65K/yr
We are growing our team in Colorado Springs, CO and have multiple Medicare Sales Agent openings available now. In this inbound call role, you will receive a competitive base salary and bonuses based ...
Health Insurance Sales Agent
Colorado Springs, CO · Hybrid
$50K - $65K/yr
We are growing our team in Colorado Springs, CO and have multiple Medicare Sales Agent openings available now. In this inbound call role, you will receive a competitive base salary and bonuses based ...
Health Insurance Sales Agent
Englewood, CO · Hybrid
$50K - $65K/yr
We are growing our team in Englewood, CO and have multiple Medicare Sales Agent openings available now. In this inbound call role, you will receive a competitive base salary, and bonuses based on ...
Health Insurance Sales Agent
Englewood, CO · Hybrid
$50K - $65K/yr
We are growing our team in Englewood, CO and have multiple Medicare Sales Agent openings available now. In this inbound call role, you will receive a competitive base salary, and bonuses based on ...
Health Insurance Sales Agent
Denver, CO · Hybrid
$50K - $65K/yr
We are growing our team in Englewood, CO and have multiple Medicare Sales Agent openings available now. In this inbound call role, you will receive a competitive base salary, and bonuses based on ...
Health Insurance Sales Agent
Denver, CO · Hybrid
$50K - $65K/yr
We are growing our team in Englewood, CO and have multiple Medicare Sales Agent openings available now. In this inbound call role, you will receive a competitive base salary, and bonuses based on ...
Health Insurance Sales Agent
Denver, CO · Hybrid
$50K - $65K/yr
We are growing our team in Englewood, CO and have multiple Medicare Sales Agent openings available now. In this inbound call role, you will receive a competitive base salary, and bonuses based on ...
Health Insurance Sales Agent
Denver, CO · Hybrid
$50K - $65K/yr
We are growing our team in Englewood, CO and have multiple Medicare Sales Agent openings available now. In this inbound call role, you will receive a competitive base salary, and bonuses based on ...
Health Insurance Sales Agent
Colorado Springs, CO · Hybrid
$50K - $65K/yr
We are growing our team in Colorado Springs, CO and have multiple Medicare Sales Agent openings available now. In this inbound call role, you will receive a competitive base salary and bonuses based ...
Health Insurance Sales Agent
Colorado Springs, CO · Hybrid
$50K - $65K/yr
We are growing our team in Colorado Springs, CO and have multiple Medicare Sales Agent openings available now. In this inbound call role, you will receive a competitive base salary and bonuses based ...
Medicare Inbound information
What are Medicare Inbound representatives?
What are the key skills and qualifications needed to thrive as a Medicare Inbound Representative, and why are they important?
What is the difference between Medicare Inbound vs Medicare Customer Service Representative?
| Aspect | Medicare Inbound | Medicare Customer Service Representative |
|---|---|---|
| Certifications | Knowledge of Medicare policies, possibly required certifications | Same certifications, focus on Medicare knowledge |
| Work Environment | Call centers, remote or office-based | Call centers, remote or office-based |
| Employer & Industry | Health insurance companies, Medicare providers | Health insurance companies, Medicare providers |
| Job Focus | Handling inbound calls about Medicare plans and coverage | Assisting customers with Medicare inquiries and issues |
Both roles involve assisting Medicare beneficiaries via inbound calls, requiring similar certifications and work environments. The main difference lies in job titles used by employers, but their responsibilities and industry context are closely aligned.
What are some common challenges faced by Medicare Inbound representatives, and how can they be managed effectively?
$16.50 - $22/hr
Other
Medical, Dental, Vision, Retirement, PTO
Re-posted 23 days ago
AdaptHealth rating
7.0
Based on 261 frontline employees who took The Breakroom Quiz
411th of 882 rated healthcare providers
Job description
AdaptHealth is a premier full-service home medical equipment company in the United States - offering a full-scope of cost-efficient HME and respiratory care products and services that aim to keep patients comfortable and thriving in their own homes. We are dedicated to pursuing better and use technology, process and the power of our national network to do so. We have a relentless commitment to using innovation to transform the durable medical equipment industry, break the status quo and provide the best quality care.
Position Summary:
Customer Service Specialistsare responsiblefor learning and understanding the entire front-end process to ensure successful service for our patients. The Customer Service Specialists works in a fast-paced environment answering inbound calls and making outbound calls. Maybe responsible for obtaining, analyzing, and verifying the accuracy of information received from referrals, creating orders, and or scheduling the patient to receive equipment as ordered by their doctor. Customer Service Specialists should educate Patients of their financial responsibility when applicable.
Essential Functions and Job Responsibilities:
- Develops and maintain working knowledge of current products and services offered by the company
- Answers all calls and emails in a timely manner, in adherence to their goals
- Documents all call information according to standard operating procedures
- Answers questions about products and services, retail stores, general service line information and other information as necessary based on customer call needs
- Processes orders, route calls to appropriate resource, and follow up on customer calls where necessary
- Reviews all required documentation to ensure accuracy
- Accurately process, verify, and/or submit documentation and orders
- Completesinsuranceverification to determine patient's eligibility, coverage, co-insurances, and deductibles
- Obtains pre-authorization if required by an insurance carrierand processphysician orders to insurance carriers for approval and authorization when required
- Navigates through multiple online EMR systems to obtain applicable documentation
- Enters and review all pertinent information inEMRsystem including authorizations and expiration dates
- Communicates with Customer Service and Management on an on-going basis regarding any noticed trends with insurance companies
- Verifies insurance carriers are listed in the company's database system, if not request the new carrier is entered
- Contacts patient when documentation received does not meet payer guidelines to provide updates and offers additional options to facilitate the referral process.
- Meets quality assurance requirements and other key performance metrics
- Facilitates resolution on customer complaints and problem solving
- Pays attention to detail and has great organizational skills
- Activelylistens to patients andhandle stressfulsituations with compassion and empathy
- Remains flexible with the actual work and the hours of operation
- Utilizes company provided tools to maintain quality. Some tools may include but are not limited to Authorization Guidelines, Insurance Guidelines, Fee Schedules, NPI (National Provider Identifier), PECOS (the Medicare Provider Enrollment, Chain, and Ownership System) and "How-To" documents
- Develops and maintains working knowledge of current HME products and services offered by the company.
- Maintains patient confidentiality and functions within the guidelines of HIPAA.
- Completes assigned compliance training and other educational programs as required.
- Maintains compliant with AdaptHealth's Compliance Program.
- Assists operations withon-call responsibilitiesas neededduring non-business hours in accordance with company policy.
- May assist Operations with deliveries.
- Retains knowledge of and consistently adheres to procedures for the use of Personal Protective Equipment (PPE), infection control and hazardous materials handling.
- Performs other related duties asassigned.
Competency, Skills and Abilities:
- Excellent customer service skills
- Analytical and problem-solving skills with attention to detail
- Decision makingskills
- Excellent ability to communicate both verbally and in writing
- Ability to prioritize and manage multiple tasks
- Proficient computer skills and knowledge of Microsoft Office
- Solid ability to learn new technologies and possess the technical aptitude required to understand flow of data through systems as well as system interaction
- General knowledge of Medicare, Medicaid, and Commercial health plan methodologies and documentation requirements preferred.
- Works well independently andas part of a group
- Ability to adapt and be flexible in a rapidly changing environment, remains patient, accountable, proactive, takes initiative and works effectively on a team
Education and Experience Requirements:
- High School Diplomaor equivalent
- One (1)yearwork relatedexperiencein health care administrative, financial, or insurancecustomer services, claims, billing, call center or management regardless ofindustry.
- Senior level requirestwo (2)yearsof work-related experience andone (1)year of exact jobexperience.
- Exact job experience is considered any of the above tasks in a Medicarecertified.
Physical Demands and Work Environment:
- Work environment may be stressful at times, as overall office activities and work levels fluctuate
- Must be able to bend, stoop, stretch, stand, and sit for extended periods of time
- Subject to long periods of sitting and exposure to computer screen
- Ability to perform repetitive motions of wrists, hands, and/or fingers due to extensive computer use
- Must be able to lift 30 pounds as needed
- May be exposed to upset customers orpatients.
- May be exposed to hazardous materials, loud noise, extreme heat/cold, direct, or indirectcontact with airborne, bloodborne, and/or other potentially infectiouspathogen.
- This position if primarily performed within an officebuilding.
- Excellent ability to effectively communicate both verbally and written with customers with the ability to demonstrate empathy, compassion,courtesy,and respect for privacy
Benefits
- Medical
- Dental
- Vision
- Paid Time Off
- 401k
#INDP
AdaptHealth is an equal opportunity employer and does not unlawfully discriminate against employees or applicants for employment on the basis of an individual's race, color, religion, creed, sex, national origin, age, disability, marital status, veteran status, sexual orientation, gender identity, genetic information, or any other status protected by applicable law. This policy applies to all terms, conditions, and privileges of employment, including recruitment, hiring, placement, compensation, promotion, discipline, and termination.
What AdaptHealth employees say
Pay
Benefits
Hours and flexibility
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About AdaptHealth
Sourced by ZipRecruiter
AdaptHealth is a prominent player in the Healthcare Technology industry, based in Phoenixville, Pennsylvania, United States. The company's official website is adapthealth.com. AdaptHealth specializes in providing home healthcare equipment, medical supplies, and related services. Founded in 2012, the company has been significantly changing the landscape of the home healthcare industry by integrating technology into the delivery of healthcare resources. Known for its dynamic approach towards improving the quality of life for chronically ill patients, their mission is to provide comprehensive home healthcare solutions aimed at promoting health, wellness, and comfort.
Industry
Outpatient health care
Company size
10,000+ Employees
Headquarters location
Plymouth Meeting, PA, US
Year founded
2012