Patient Care Representative

  • Aveanna Healthcare
  • Phoenix, AZ, USA
  • Nov 25, 2021
Full time Health Care

Job Description

Position OverviewThe Patient Care Representative is responsible for providing a high level of customer service to our patients and their caregivers from intake to discharge. The primary function of this position is accurate documentation and verification of intake, changes, reorder and discharge. The Patient Care Representative is responsible for accurate and detailed database entry based on complete information collected and updated on a regular basis.Essential Job FunctionsProcess patient intake and admissions; verify patient eligibility and benefits and receipt of all documents needed to request authorization as required.Calculate patient enteral needs based off prescription, request authorization from health plans and complete data entry within system to ensure accurate patient data.Obtain clinical information needed for order processing or reimbursement.Contact patients to: advise them of the order placed on their behalf and to confirm all patient demographic information; to communicate any financial responsibilities and/or additional information necessary for processing the order received; to promote other company product and services as appropriate.Ensures patient information is accurate, including demographic data, prescriptions, physician data, insurance eligibility and coverage.Review and work the pending Start of Care (SOC) report daily to ensure that accounts are not aged over threshold and ensure pending status is updated throughout process.Contact patients on a monthly basis to review and confirm delivery details to ensure timely delivery and appropriate revenue recognition for order.Complete QA review for all new starts – Maintain 90% or higher QA score. Completes QA corrections as required and ensures that initial claims are clean and billable.Support the Aveanna mission and culture by demonstrating our core values; compassion, team integrity, accountability, trust, innovation compliance and fun.Adhere to the Aveanna Compliance Program, including following all regulatory, Aveanna and accrediting agency policy requirements.Maintain the skills and qualifications necessary to provide or support quality care, including attendance at company-wide educational programs.Responsible for submitting accurate time and attendance records and following proper procedures for reporting and making corrections to attendance records. Responsible for harmonious interactions with coworkers and customers, including patients, medical office staff, vendors and the general public.Upon employment, all employees are required to fully comply with Company’s policies and procedures. The above statements are intended to describe the general nature and level of work being performed.  They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of employees in this position.Position QualificationsMinimum Education: High school diploma or GEDPreferred Education: Associates Degree in medical office management or relatedMinimum Experience: Two years in a related administrative/customer service role; healthcare or medical office and 6 months working with healthcare insurance.Preferred Experience: Insurance authorization and/or precertification. Knowledge of home health, DME and Enteral nutrition products.Required Certification/ License: n/aPreferred Certification/ License:Supervises: n/aSpecial Skills: Proficient in Microsoft suite of products including Outlook, Word and Excel. Strong basic math and accounting skills. Strong critical thinking and problem solving skills. Must possess a strong sense of urgency and attention to detail. Excellent written and verbal communication skills. Proven ability to work independently at times and within a team. Ability to adapt to change. Demonstrated ability to prioritize multiple tasks to meet deadlines. Demonstrated ability to interact in a collaborative manner with other departments and teams.