This job was posted by https://illinoisjoblink.illinois.gov : For more
information, please see:
https://illinoisjoblink.illinois.gov/jobs/11903305
Basic Function: Under the direction of the Billing Manager, this
position is responsible for all documentation activities relating to
timely transitions of care. Principle Responsibilities: Gathers
documentation needed to support medical necessity to submit Prior
Authorization for Durable Medical Equipment. Submit and maintain prior
authorizations Submit and maintain all certificate of medical necessity
(CMN) Receives appropriate paperwork and prescriptions as required
Request documentation pertaining to continued need for PAP and Oxygen
patients Review and Complete Stop/Hold report for documentation related
stops and holds Enters all patient notes into EMR and verifies all
information is complete and accurate Knowledge of Medicare LCD\'s and
Qualifications for home medical equipment Maintain current knowledge of
Medicare, Illinois Public Aid and insurance industry policies and
guidelines Interacts in strict adherence to HIPPA compliance regulations
and related company policies Upload required documents to the patient
account Responds to customer requests courteously and with respect
Approaches customers and inquiries in a manner which represents
ownership Resolves customer complaints by investigating problems and
making recommendations to executive leadership Refers troubleshooting
calls to appropriate department Reports any patient or referral related
problems to Lead immediately Build and maintain positive relationships
with referral sources to include education on medical equipment
qualification and policy changes Promote company program and services to
assigned referral source. Meets monthly and quarterly productivity goals
Adherence to the Prism\'s Employee Handbook Adherence to Prism\'s
Policies and Procedures Supports the mission, vision and strategic plan
of the organization. Contributes to team effort by accomplishing related
results Communicate necessary information to the Managers and Co-workers
Participate in on-call schedule rotation Attend in-service training when
required Performs other duties as assigned