Patient Account Liaison

Electromed Inc.•New Prague, MN

5d•$22 - $30•Hybrid

About The Position

The Patient Account Liaison (PAL) is responsible for reviewing and processing new referrals from patient intake to shipping and insurance approval. The PAL is the primary contact for patients, clinics, and Clinical Area Managers within their designated territory with responsibilities including patient intake and contact throughout the referral process, obtaining payer required documentation, submitting, and obtaining insurance authorizations, obtaining patient documents, and assisting with patient payment programs.

Requirements

High School diploma or GED required; degree preferred
Extensive customer service experience with phone contact, preferably in a call center environment
Substantial experience working directly with providers in healthcare or DME setting
Strong and solid experience working with insurance companies in the capacity of benefits & coverage, and authorizations
Previous experience in medical device or other healthcare environments required
Proficiency working with Microsoft Office suite
Knowledge of medical terminology
Familiarity of medical documentation
Knowledge of Protected Patient Info and HIPAA laws
Proven and recurring success working directly with sales teams preferred
Experience with DME billing preferred
Experience with Medicare part B coverage
Experience with national payers
Knowledgeable of insurance requirements with the ability to determine medical justification to ensure proper reimbursement
Strong knowledge of medical insurance benefits and authorization processes

Responsibilities

Follow Electromed mission and core values, while striving to achieve company goals
Understand and adhere to local State and Federal healthcare regulatory and compliance rules
Responsible for maintaining patient flow and relationships with physicians and their staff, discussing treatment options, providing nurse and patient education. Act as main point of contact between physician, patient, and Clinical Area Manager (CAM)
Review new patient referrals and intake information for required documentation and medical necessity, insurance, demographics, clinical history, etc.
Collect and organize medical records, maintain electronic charts including comprehensive care plans, medical information, treatment records and billing data
Ensure patients have proper authorizations for treatment coverage, perform benefit verification and submission of authorization requests.
Develop payer knowledge base related to diagnosis, coverage guidelines and medical criteria
Communicate professionally and effectively; requires extreme attention to detail, problem resolution, and knowledge of medical terminology, Protected Patient Info and HIPAA laws
Develop relationships with patients and providers by maintaining exceptional service and follow up care
Educate patient on the therapeutic benefits of the SmartVest to promote prescribed adherence
Discuss therapy and treatment costs, collect, and update necessary patient information and forms for insurance processing
Assist internal and field team, payers, and patients in understanding payer methodologies and resolution of order-related issues through outreach and response to inquiries
Effectively submit insurance requests to obtain authorization, utilizing tools such as web portals and authorization partners.
Primary contact for providers & patients prior to the shipment of their device
Provide order status updates for incoming calls from patients, clinics, and sales representatives
Initiate and arrange product shipment, including determining device and garment selection
Quickly and accurately identify and assess individual customer needs, determining appropriate action and taking ownership to ensure positive resolution
Work closely with referring MD offices and internal team to provide timely service to patients
Ensure the accuracy of referral and patient data entered into system by verifying information received
Ensure proper documentation and data is received in a timely manner
Other duties as assigned