AdaptHealth

Insurance

• Intake Specialist responsibilities: accurate and timely data entry; understanding, and selecting inventory/services in key databases; communicating with referral sources; utilizing technology to notate patient information/communication.
• Answer inbound calls and make outbound calls; obtain, analyze, and verify the accuracy of information received from referrals; create orders; schedule the patient to receive equipment as ordered by their doctor.
• Intake Specialists educate Patients of their financial responsibility when applicable.
• Review and enter referrals into appropriate systems; ensure documentation is routed to appropriate physician for signature/completion.
• Work with local branch leadership to ensure inventory/services are provided; support regional team functions as necessary.
• Verify insurance coverage, determine eligibility, co-insurances, and deductibles; obtain pre-authorization if required; process orders to carriers for approval; resolve coverage issues.
• Communicate with Customer Service and Management regarding trends with insurance companies; ensure QA and performance metrics are met
• Maintain knowledge of payer guidelines, payer coverage, and expiration dates as needed

Insurance Verification Specialist

Customer Support

• Develop and maintain working knowledge of current products and services offered by the company
• Answer all calls and emails in a timely manner, in adherence to their goals
• Document all call information according to standard operating procedures
• Answer questions about products and services, retail stores, general service line information and other information as necessary based on customer call needs
• Process orders, route calls to appropriate resource, and follow up on customer calls where necessary
• Review all required documentation to ensure accuracy
• Accurately process, verify, and/or submit documentation and orders
• Complete insurance verification to determine patient’s eligibility, coverage, co-insurances, and deductibles
• Obtain pre-authorization if required by an insurance carrier and process physician orders to insurance carriers for approval and authorization when required
• Must be able to navigate through multiple online EMR systems to obtain applicable documentation
• Enter and review all pertinent information in EMR system including authorizations and expiration dates
• Communicate with Customer Service and Management on an on-going basis regarding any noticed trends with insurance companies
• Verify insurance carriers are listed in the company’s database system, if not request the new carrier is entered
• Responsible for contacting patient when documentation received does not meet payer guidelines to provide updates and offer additional options to facilitate the referral process.
• Meet quality assurance requirements and other key performance metrics
• Facilitate resolution on customer complaints and problem solving
• Pays attention to detail and has great organizational skills
• Actively listens to patients and handle stressful situations with compassion and empathy
• Flexible with the actual work and the hours of operation
• Utilize company provided tools to maintain quality. Some tools may include but are not limited to Authorization Guidelines, Insurance Guidelines, Fee Schedules, NPI (National Provider Identifier), PECOS (the Medicare Provider Enrollment, Chain, and Ownership System) and “How-To” documents

Insurance Verification Specialist

Customer Service Specialist