Home Medical Equipment Customer Service Coordinator

Advocate Aurora Health • West Allis, WI

110d • $22 - $33 • Remote

About The Position

The position involves evaluating HME referral and service order requests to ensure a smooth and timely transition for patients from hospital to home, while ensuring patient safety and optimizing insurance benefits. The role requires advocating for patients, serving as a liaison to explain prescription orders, hospital transitions, and home start of care processes. Responsibilities include verifying patient insurance benefits, contacting insurance plans for prior authorization, and providing direction to physicians regarding documentation gaps. The position also involves coordinating timely service provision, providing quality customer service, and ensuring current authorizations for managed care clients. The team member will monitor insurance verification reports, collect and submit data to management, and assess potential third-party liability cases. Additionally, the role requires negotiating payment plans with patients and participating in performance improvement initiatives.

Requirements

• High School Graduate.
• Typically requires 5 years of experience in medical entry, claims processing, HME business line, home care, insurance verification, or healthcare customer service.
• Knowledge of HME/RT equipment.
• Understanding of third-party payors, including Medicare, Medicaid, and private insurance companies.

Nice To Haves

• Experience with electronic referrals and HME coding.
• Strong data entry and phone skills.
• Ability to function under tight time constraints.

Responsibilities

• Evaluate HME referral and service order requests for patient transitions from hospital to home.
• Advocate for patients and explain prescription orders and insurance benefits.
• Verify patient insurance benefits and eligibility, and obtain service prior authorization.
• Provide direction to physicians on documentation and medical management gaps.
• Identify risk issues and collaborate with care providers to ensure patient safety.
• Coordinate timely provision of services with distribution operations.
• Provide quality customer service to patients, physicians, and referral sources.
• Ensure current authorizations for managed care clients.
• Monitor and work on insurance verification reports.
• Collect and submit data to management for assigned reports.
• Assess potential third-party liability cases and relay billing requirements.
• Provide pricing information and negotiate payment plans with patients.
• Participate in performance improvement and patient satisfaction initiatives.

Benefits

• Paid Time Off programs.
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability.
• Flexible Spending Accounts for eligible health care and dependent care expenses.
• Family benefits such as adoption assistance and paid parental leave.
• Defined contribution retirement plans with employer match.
• Educational Assistance Program.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Hospitals
• Education Level: High school or GED