Order Specialist | Home Plus

Monument Health•Rapid City, SD

3d•$18 - $22•Onsite

About The Position

The Order Specialist works with customer accounts in reviewing all orders for completed documentation and accurate insurance processing. The Order Specialist validates database, customer documents, and insurance records for proper regulation submission. This position will maintain accurate records of customer information and products and ensure an effective experience for the customer.

Requirements

High School Diploma/GED Equivalent
3+ years Home Medical Equipment Experience
3+ years Healthcare Experience
3+ years Customer Service Experience

Responsibilities

Creates customer profiles for all new customers.
Verifies and updates customer demographics and insurance information in the system of record.
Generates sales orders and purchase requests for medical equipment prescribed to patients.
Demonstrates knowledge of third-party payer information, including Medicare, Medicaid, VA, Tricare/UHC and commercial payers, to ensure compliance with rules and regulations to maintain accurate reimbursement.
Analyze insurance claims to ensure all required documentation is obtained and meets regulatory insurance standards.
Evaluate outstanding orders and process for proper completion.
Follows up with all customers on order status; resolves any requests or issues received from customers.
Works with insurance providers to resolve claim issues.
Researches and reworks all claim kickbacks, rejections, and denials.
Review medical records to ensure orders are consistent with multiple insurance regulations.
Request necessary additional required documents from providers prior to processing claims in accordance with primary payer specifics and billing requirements.
Coordinates deliveries with technicians and customers.
May assist in the preparation and packaging of packages for delivery or mailing.
Answer incoming phone calls while maintaining an open line of communication between departments & customers.
Assisting walk-in customers with retail sales and supply orders.
Knowledge of DME (Durable Medical Equipment) product and providing education/fitting as needed.
Manages product inventory and maintains an organized retail area.
Performs point of service collections including prepayments, outstanding balances, co-payment and co-insurance; daily reconciliation of cash drawer.
Provides patients with basic account reconciliation.
All other duties as assigned.