The duties of the Patient Support Specialist are similar to those of the Patient Support Representative as outlined in this position summary. They differ in that the Specialist works in areas of HME with a higher degree of complexity (e.g. Complex RT, General HME). The Patient Support Specialist is responsible for the collection of demographic and financial information from patients to ensure a smooth onboarding to services provided by UW Health Care Direct. This job has the responsibility for the verification of patient eligibility for insurance benefits, including but not limited to, Medicare, Medical Assistance, and numerous third-party payers to ensure adequate and timely reimbursement.
The Patient Support Representative is responsible for setting expectations and providing responsive communication to patients, providers and other internal and external stakeholders regarding the status of their order. Creation and management of sales orders in Brightree is also a core responsibility.
Job Requirements
Licenses: N/A
Education: High school diploma or equivalent required
Experience: Customer service experience required
Minimum of three years of experience in healthcare required
Experience with home medical equipment preferred
Miscellaneous: Ability to learn and competently work with coworkers, referral sources and patients required. Must have the ability to learn and work with computer programs such as Health Link (Epic) and Brightree. Proficient in medical terminology and abbreviations.
Technical Responsibilities
· Complete, accurate, and timely verification and entry of all patient demographics
· Obtain and review clinical documentation to ensure insurance guidelines are met for the equipment or supplies ordered
· Obtain purchase and initial rental prior authorizations
· Convey insurance benefits and out of pocket costs to the patient
· Complete accurate and timely sales order entry of the item(s) requested
· Responsible for answering incoming phone calls regarding a multitude of questions or concerns, working to establish a positive rapport and meet the needs of every caller
· Responsible to returning patient and provider phone calls, helping assist in getting the patient qualified for needed equipment
· Schedule appointments for setup and delivery or pickup of equipment.
· Responsible for timely follow up of all tasks, this will include a variety of sales order related issues, CMNs, prior authorizations, patient questions, etc.
· Manage inbound faxes/referrals, including the UW In Basket and email
· Provides basic team related training to new staff and peers
· Performs other duties as assigned
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