This job was posted by https://illinoisjoblink.illinois.gov : For more information, please see: https://illinoisjoblink.illinois.gov/jobs/11903305

Basic Function: Under the direction of the Billing Manager, this position is responsible for all documentation activities relating to timely transitions of care. Principle Responsibilities: Gathers documentation needed to support medical necessity to submit Prior Authorization for Durable Medical Equipment. Submit and maintain prior authorizations Submit and maintain all certificate of medical necessity (CMN) Receives appropriate paperwork and prescriptions as required Request documentation pertaining to continued need for PAP and Oxygen patients Review and Complete Stop/Hold report for documentation related stops and holds Enters all patient notes into EMR and verifies all information is complete and accurate Knowledge of Medicare LCD\'s and Qualifications for home medical equipment Maintain current knowledge of Medicare, Illinois Public Aid and insurance industry policies and guidelines Interacts in strict adherence to HIPPA compliance regulations and related company policies Upload required documents to the patient account Responds to customer requests courteously and with respect Approaches customers and inquiries in a manner which represents ownership Resolves customer complaints by investigating problems and making recommendations to executive leadership Refers troubleshooting calls to appropriate department Reports any patient or referral related problems to Lead immediately Build and maintain positive relationships with referral sources to include education on medical equipment qualification and policy changes Promote company program and services to assigned referral source. Meets monthly and quarterly productivity goals Adherence to the Prism\'s Employee Handbook Adherence to Prism\'s Policies and Procedures Supports the mission, vision and strategic plan of the organization. Contributes to team effort by accomplishing related results Communicate necessary information to the Managers and Co-workers Participate in on-call schedule rotation Attend in-service training when required Performs other duties as assigned