This position works as a member of a team to ensure reimbursement for services in a timely and accurate manner. Responsible for obtaining and maintaining all supporting documents required by government agencies and other insurance companies for appropriate reimbursement of home medical equipment. Provides administrative services and assistance. Coordinates processes for an assigned area such as but not limited to claims, transitions, loan closets, selection, validation or billing.
Obtains and maintains physician orders, authorizations, Certificates of Medical Necessity (CMN) and other supporting documents to ensure reimbursement from government agencies and insurance companies for medical equipment services.
Attends in-service education and training on policy, procedure, and work related material such as ADR (Medicare - Additional Documentation Request).
Acts as an internal resource for qualifying criteria, payment limitations and required documentation. Provides assistance to patient financial services regarding accurate patient account charges. Verifies the accuracy of required documentation. Examines and tracks all orders to ensure proper billing. Verify balances and receipts for all form of payments then completing an End of Day report.
Schedules and maintains CMNs and physician's orders for timely delivery and enters completed order into billing system for reimbursement.
Research/responds to overdue/delinquent accounts and follows up by mail and/or phone to resolve in a timely manner.
Research customer accounts thoroughly and documents appropriately, processes adjustments when services are non-covered or been denied.
High school diploma/GED or equivalent working knowledge.
Skills and abilities normally gained with 2-3 years of experience in patient accounts, pharmacy or equipment intake. This position requires a thorough understanding of regulatory and accreditation requirements of medical equipment and infusion medications for government and third party agencies to ensure compliance and appropriate reimbursement.Requires effective interpersonal skills, with ability to provide effective customer service. Demonstrated organizational and problem solving skills are needed.Ability to keep detailed records regarding equipment and medical records. Ability to communicate effectively. Able to prioritize and organize daily work.Demonstrated ability to use and develop proficiency with computers and office software.
1-2 years of experience in clerical, customer relations and/or customer service departments is preferred.
Additional related education and/or experience preferred.
You want to change the health care industry – one life at a time. You belong here. You’re excited to be part of the dramatic changes happening in the health care field. In fact, you thrive on change. But you also understand that excellent, compassionate patient care is the true measure of the success of these changes. You belong at Banner Health. Our award-winning, comprehensive health system includes 23 hospitals in seven western states, primary care health centers, research centers, labs, a network of physician practices and much more. Throughout our system, skilled, compassionate professionals use the latest technology to change the way care is provided. If you’re looking to be a key contributor to a forward-looking organization, you’ll experience a wide variety of professional advantages: •Our vision for changing the future of health care gives you the opportunity to leverage your abilities to achieve something historic. •Our expansive system offers you an unmatched variety of clinical settings – from large urban trauma center to small rural hospital, ambulatory to home health. Our system also includes hospitals specializing in cancer, heart health and pediatrics. •Our many loc...ations also translate into a broad selection of exciting and rewarding lifestyle options – from the big city to the wide-open spaces. •Our commitment to healthcare innovation means you always have the latest technologies at your fingertips to help you provide the finest care possible. •The size, success and growth of our system provide you with the stability and options to pursue your desired career path. •Our competitive compensation and comprehensive benefits offer you options to complement your unique needs.