Job Description
Department Home Medical Equipment Services Exempt Immediate Supervisor HME Manager Non-exempt Supervisor next COO Workweek 40 hours in line
POSITION SUMMARY
The Patient Billing & Customer Service Representative (CSR) is a non-clinical, front-line position that provides comprehensive support to patients and respiratory therapists, focusing on durable medical equipment (DME) orders, insurance billing, and ensuring high-quality customer service. This role involves direct interaction with patients, assisting them with equipment orders, insurance verification, and resolving any billing or service-related issues. The CSR also works closely with respiratory therapists to ensure patients receive the appropriate equipment and care in a timely and efficient manner. Continued employment and raises in this position are dependent upon Central Montana Medical Center's fiscal viability and: Actions and communications that contribute to a team concept and create a positive environment for all customers Acceptable performance of essential and all job duties. Continued improvement on the Bright Tree software system Must understand and follow MLN 8304
directives. Acceptable attendance record Accountability for safety to self, patients, visitors and all customers, and care of equipment and building Adherence to departmental and facility policies and procedures, education requirements, compliance monitoring and reporting, and CMMC Code of Conduct Accountability for the consequences of own actions Physical and emotional ability to perform essential functions Acceptable background investigation results if required for position Minimum Education, Experience, Licensure, Certification required: EDUCATION
High school Degree of equivalent. EXPERIENCE
Background in HME or other medical billing is preferred. SKILLS:
Experienced in customer service, billing systems, and accurate data entry. Strong communicator with excellent phone etiquette and attention to detail. Organized and proficient with computers and software. ESSENTIAL FUNCTIONS/DUTIES
(Must be able to perform with or without accommodation) 1 Patient Support & Education:
Assist patients with durable medical equipment (DME) orders and answer related questions. Educate patients on equipment usage, ensuring they understand how to safely use the equipment. Ensure that the equipment provided is documented, appropriate, and meets patient needs. Educate patients on the billing process, ensuring they have a clear understanding of costs and charges. 2 Insurance & Billing Support:
Verify insurance coverage and benefits for equipment and services, including pre-authorizations when necessary. Understand and apply Medicare/Medicaid regulations and how they relate to other insurance carriers to ensure compliance and proper billing. Address and resolve billing and service-related issues, ensuring accurate billing practices. Auditing, editing, and reviewing claims before confirmation to eliminate rejections, resubmission, and follow-up problems. Position:
HME Billing/CSR CUSTOMER SERVICE REPRESENTATIVE 3
Collaboration & Communication:
Work closely with respiratory therapists to ensure appropriate care and equipment is provided. Refer to respiratory therapists for clinical information or care for patients. Utilize effective communication tools to interact with departments, physicians, and customers in relation to DME product procurement and reimbursement. Keep the DME manager aware of any problems or potential issues, ensuring smooth communication across teams. 4 Documentation & Compliance :
Maintain accurate patient records, ensuring compliance with privacy regulations (e.g., HIPAA). Adhere strictly to CMMC's patient confidentiality guidelines in dealings with staff and the community. Understand and follow departmental policies and procedures, including safety, environmental, and infection control standards. 4 Follow-Up & Tracking:
Track order progress, following up on outstanding tasks or issues to ensure timely resolution. Manage time effectively, being flexible and assist other staff members during downtime. 5 Customer Service & Support:
Provide high-quality customer service, addressing concerns promptly and ensuring a positive experience for patients and their families. Resolve issues promptly and efficiently to maintain high satisfaction levels. 6 Miscellaneous Duties:
Be flexible and take on additional duties as requested or assigned. Knowledge, Skills, Abilities:
Willingness to promote CMMC HME
in a positive manner on and off the workplace. Willingness:
To assume additional duties when requested and to assist others when indicated. Ability to adapt to fluctuations in workload. Ability to read, write, perform basic mathematical computations, and follow written and oral directions. Willingness to look for ways to improve patient care and promote cost effectiveness in doing so. Ability to provide supervision to subordinates with tact and full assertiveness. Ability to learn quickly various computer software programs. Ability to anticipate the HME department's needs such as inventory or coming rules and regulations. Ability to work under timelines. Judgement to seek guidance and direction from the coordinators or manager when needed, for performance of duties and ability to recognize, establish and respond to priorities. Communication skills to effectively relate to/with patients/customers, physician office staff, co- workers, subordinates' families, and the public. OCCUPATIONAL EXPOSURE
for this position: Category I Direct contact with blood or other bodily fluid to which universal precautions apply Category II Activity performed without blood/bodily fluids exposure, but exposure may occur in emergency Category III Task/activity does not ordinarily entail predictable exposure to blood/bodily fluids OTHER EXPOSURE
for this position: Radiation Noise Other (Specify) Position:
HME Billing/CSR CUSTOMER SERVICE REPRESENTATIVE PHYSICAL DEMANDS
: (Essential functions strength rating for position - see Job Analysis) Sedentary Exert up to 10# occasionally or negligible force frequently Light Exert up to 20# occasionally, < 10# frequently or negligible force constantly Medium Exert up to 50# occasionally, up to 25# or up to 10# constantly Heavy Exert up to 100# occasionally, up to 50# frequently or up to 20# constantly Very Heavy Exert > 100# occasionally, > 50# frequently or > 20# constantly
