Patient Service Representative

Position Summary

Key Responsibilities

Order Processing & Billing Support

• Process patient order confirmations and updates to support revenue recognition and billing
• Review equipment setup documentation for completeness, accuracy, and required signatures
• Generate and review daily Confirmed Orders for Billing reports; identify and correct errors
• Investigate and resolve open orders to ensure timely billing and service confirmation

Insurance & Authorization Management

• Verify insurance eligibility and benefits (e.g., Medicare, Medicaid, BCBS, HMOs, Managed Care)
• Ensure required authorizations are current and in place for supplies and purchased items
• Identify and validate reimbursement sources

Direct Billing (Off-Site Locations)

• Enter direct billing charges for supply items dispensed at off-site locations
• Obtain and validate diagnosis codes from patient records or delivery documentation
• Create or update patient accounts with demographic and insurance information
• Complete monthly bulk billing for non-covered or out-of-network items

Patient Records & Documentation

• Prepare, scan, and index patient documentation into the EMR system
• Ensure document quality, accuracy, and proper indexing by patient and document type
• Manage storage and secure destruction of records per policy
• Operate and troubleshoot scanning/imaging equipment

Reporting & Account Maintenance

• Run and analyze operational reports (e.g., Open Orders, Discharge, Continued Use)
• Update inactive accounts and ensure compliance with payer guidelines
• Support tracking and follow-up of lost or unrecovered equipment

Customer Service & Coordination

• Respond to patient and internal inquiries regarding equipment, documentation, and billing
• Coordinate with Intake and Distribution teams to resolve delivery or service issues
• Provide backup phone support and assist walk-in patients as needed
• Escalate safety concerns (e.g., oxygen handling risks) to appropriate stakeholders

Additional Duties

• Compile and submit assigned operational reports (e.g., Daily Order Report)
• Perform other duties as assigned

Education & Experience

• High School Diploma or equivalent required
• 3–4 years of administrative or office experience required (healthcare preferred)
• Experience with third-party payors (Medicare, Medicaid, commercial insurance) required
• Knowledge of medical terminology preferred
• Home care or HME experience preferred

Knowledge, Skills & Abilities

• Strong data entry accuracy and attention to detail
• Excellent organizational and time management skills
• Effective communication and customer service skills
• Ability to work independently with minimal supervision
• Proficiency with computer systems and EMR platforms (e.g., OnBase, Fastrack, CareNet, ERMA, Care Connection preferred)

Work Environment & Physical Requirements

• Office/healthcare administrative setting
• Prolonged computer use and sitting
• Occasional lifting of files or office materials