Careers

Home Plus Order Specialist

Sturgis, SD Full time 21_1066

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Job Category

Patient Services

Department

Home Plus ST HME

Scheduled Weekly Hours

40

Shift

Employee Type

Regular

Job Summary

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 regulatory submission. This position will maintain accurate records of customer information and products and ensure an effective, prompt experience for the customer.

Job Description

Essential Functions:

  • Creates customer profiles for all new customers. Verifies and updates customer demographic and insurance information in the system of record.
  • Generates sales orders and purchase requests for medical equipment prescribed to patient.
  • 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. Requests 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.
  • All other duties as assigned.

Additional Requirements

Required:

Education - High School Diploma/GED Equivalent

Experience - 3+ years Customer Service;

Preferred:

Experience - 3+ years Home Medical Equipment Experience; 3+ years Healthcare Experience

Light work - Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects.

40 Regional Health Home Plus

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Monument Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status.

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