This employee verifies insurance eligibility, reviews and obtains necessary documentation to fulfill insurance medical policy guidelines, and requests key authorizations and CMNs.
Job Responsibilities:
Pull, process, and release pending orders from the CPAP Call Queue Pull and process authorization request submitted from the field through the CMN Centralized Review/CAD program Pull and process authorization requests submitted through the PACD queue in LITE Order Entry Process items received through PAR Task Tracker in LITE Update items as needed in LITE Customer Master Update items as needed in IBMi Customer Maintenance Key authorizations and CMNs on accounts Work Held Sales with the ability to delete and restart billing as needed Upload authorizations and medical documentation to the patient's EMR through Medforce and/or Document Task Tracker and PAR Task Tracker in LITE Create and print CMNs to submit to physician offices #
CC Requirements:
Must have some knowledge of computer skills Write, read, and comprehend simple instructions, short correspondence, and/or memos Effectively present information in one-on-one and small group situations to customers, physician offices, and employees of the organization Add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals, as well as compute rate, ratio, and percent Multitask and prioritize