Job Description

Job Title: Hospital and Nursing Account Manager-Customer Support Specialist (Chartwell)
Job ID: 28310696
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility: UPMC Community Provider Svcs
Department: Pharmacy
Location: 1001 Oakdale Road, Oakdale PA 15071

Description

Responsible for the daily functions of the insurance verification area including verification of insurance coverage, entering and updating patient demographics into the patient management system, communication of financial responsibility and securing reimbursement related paperwork. Also responsible for performing select activities related to the management of enteral therapy, including development of the plan of treatment based on physician order, patient supply management, processing delivery tickets and coordinating new/existing patient services with patient/caregiver, nursing and operations.

Responsibilities:

  • Assists in researching reimbursement issues.
  • CommunicationDemonstrates ability to communicate effectively and express ideas clearlyTakes initiative to present ideas/suggestions to management.Utilizes appropriate communication lines in relaying problems, concerns, questions and ideas.
  • Works with referral source/liaisons to obtain supporting documentation to qualify Medicare patients
  • Obtains authorization/precertification as required by payer.
  • Payment Agreements, waivers and secures drug donations.
  • Coordinates documentation as required by payers, MMAOB, ABN.
  • Assists in price negotiation with case managers.
  • Reviews benefits and financial responsibilities with referral sources, patients or family members.
  • Clarifies prescriptions with MD office staff as needed.
  • Notifies agencies when deliveries will arrive and fax orders to agencies.
  • Verifies patients' insurance benefits for therapies prior to discharge from the hospital.
  • Completes paperwork and coordinates the entry of new payers into the patient management system as needed.
  • Performs daily follow up with hospital staff to check on possible discharges.
  • Receives referrals via fax
  • Places patient/order information on ESDL and coordinates timed deliveries.
  • Completes insurance checks on a daily basis as needed.
  • Works with the warehouse manager and/or director of operations to order new products as needed.
  • Writes Plan of Treatment documents for all enteral orders.
  • Enters and updates patient demographics and services into the patient management system.
  • Works Registration Tracking Log on a daily basis as needed.
  • Generates price quotes and completes payer requirement paperwork, ABN, etc.
  • Writes Weekend Report.
  • CUSTOMER SERVICE ORIENTATIONGives high priority to client satisfaction and customer needs.Maintains confidentiality of patient informationMaintains courteous demeanor at all times.
  • Enters template, supplies and all equipment into patient management system
  • Reviews referral information with patients and caregivers before coordinating deliveries.
  • WORK STANDARDSCarries out all responsibilities in accordance with the Chartwell Core Values.Sets high goals or standards of performance for self.Makes sure that work meets quality standards.Shows pride in work.Demonstrates reliability and follow-through on all assigned tasks.
  • Coordinates completion of Financial Assistance Forms,
  • Verifies if any supplies are needed with re-referrals.

Qualifications

  • 2 year college degree or equivalent business / healthcare related experience required.
  • 2-3 years of experience in DME (enteral), billing/collections and/or insurance verifications preferred.
  • Knowledge of medical terminology desired. 
  • Basic computer skills required (Microsoft Word, Outlook).
  • Excellent organizational and communication skills required.
  • Previous customer service experience required.
  • Capable of managing multiple priorities in fast paced office.

    Licensure, Certifications, and Clearances:
  • Act 34

  • UPMC is an Equal Opportunity Employer/Disability/Veteran

    Salary Range: $17.97 to $29.87 / hour

    Union Position: No

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