Customer Support Humana Intake

About Rotech

Rotech Healthcare Inc. is a national leader in providing ventilators, oxygen, sleep apnea treatment, wound care solutions, diabetic solutions and home medical equipment. We help patients lead a more comfortable and productive life by keeping them engaged in their care and empowering them to manage their health and treatment at home. Rotech provides high quality medical products, services and outstanding customer care through hundreds of locations across 45 states. For additional information, visit our company homepage Rotech.com

Overview And Responsibilities

Job Summary

We are seeking a dedicated Customer Support Centralized Humana Intake Team to join our team. In this position, you will provide support to the customers of the Support Center working exclusively with Humana Contracts to assist the field by performing tasks related to patient care and third party reimbursement. Primarily responsible for new order intake to encompass accuracy with clinical, billing and care related information and processing.

Essential Job Duties And Responsibilities

(Reasonable accommodations may be made to enable individuals with disabilities to perform these essential functions. Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.)

• Turnaround time per Humana SLA is 24 hours or less for DME order
• Responsible for ticket creation
• Responsible for responding to email inquiries in a timely manner ( [email protected] )
• Responsible for downloading the rejection and physician outreach attempts and uploading in the patient's EMR
• Responsible for selecting the correct Transcodes for DME Drop Ship option
• Responsible for obtaining authorization or PCP referral if necessary
• Responsible for selecting the correct Transcodes for each Humana Plan
• Responsible for account creation, linking, ins. eligibility, choosing the correct plan from many Humana options ie. FFS or Capitated
• Responsible for ensuring the equipment ordered is covered per the contract agreement
• Performs other duties as assigned
• Training on Humana Contract guide and understanding QRG and Contract stipulations
• Responsible for clearing all holds in OIP to Ready to manifest
• Responsible for following up with the patient for DME dropship option
• Responsible for voiding out tickets if documentation is not received after three failed attempts
• Responsible for re-directing orders to appropriate locations for sub contracts and Adapt in States where we did not win bid
• Responsible for immediate rejection if deemed necessary
• Responsible for sending DME dropship orders to Lawson and ensuring Serial # is entered for specific items if needed
• Responsible for sending the ticket back to the location for fulfillment in a timely manner and coordinating delivery with locations
• Responsible for following up with physician (3 attempts) to obtain documentation, if needed
• Responsible for QA (ensuring medical necessity is met) per MCR guidelines
• Responsible for adding detailed notes to the account
• Responsible for manual confirmation of DME drop ship items
• The team will need to follow three process flows vs one

Qualifications

Employment is contingent on

• Valid driver’s license in state of residence with a clean driving record (when applicable for the position)
• Background investigation (company-wide)
• Drug screen ( when applicable for the position )

Required Education And/or Experience

• High school diploma or GED equivalent, required

Preferred Education And/or Experience

• Experience in medical field and administrative record management, preferred
• One year of related work experience, preferred
• Experience with medical billing practices and of billing reimbursement, preferred

Skills And Competencies

• Effectively communicate in English; both oral and written
• Multi-task along with attention to detail
• Accurately perform simple mathematical calculations
• Interpret a variety of communications (verbal, non-verbal, written, listening and visual)
• Work independently and as part of a team
• Self-motivation, organized, time-management and deductive problem solving skills
• Maintain confidentiality, discretion and caution when handling sensitive information

Machines, Equipment And Technical Abilities

• Email transmission and communication
• Microsoft applications; Outlook, Word and Excel
• Office equipment; fax machine, copier, printer, phone and computer and/or tablet
• Internet navigation and research

Physical Demands

• Requires sitting, walking, standing, talking and listening
• Requires close vision to small print on computer and/or tablet and paperwork
• Lift and carry office equipment at times

Rotech Information

Benefits

• Life Insurance and Disability
• Telephone reimbursement (when applicable for the position)
• Mileage reimbursement (when applicable for the position)
• Generous Paid Time Off and Paid Holidays
• Bonus and Incentive Opportunities
• Medical, Dental and Vision
• 401k

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Equal Opportunity Employer of Minorities, Females, Protected Veterans and Individuals with Disabilities. Rotech Healthcare Inc. recruits, employs, trains, promotes, transfers, separates from employment and compensates employees without regard to membership in, association with, or perception of race, color, age, gender, gender identity, religion, creed, national origin, ancestry, citizenship, marital status, veteran status, sexual orientation, physical or mental disability, pregnancy or any other personal characteristic protected by applicable federal, state and local laws governing nondiscrimination in employment in each locality where Rotech has employees.