Patient Account Liaison

Summary

Electromed, Inc. develops, manufactures, and markets airway clearance devices that help people breathe better and stay healthier. The Patient Account Liaison reviews and processes patient referrals through shipping and insurance approval, serving as the primary contact for patients, clinics, and Clinical Area Managers while managing documentation, authorizations, payment programs, and patient support.

Responsibilities

• Follow Electromed mission and core values, while striving to achieve company goals
• Understand and adhere to local State and Federal healthcare regulatory and compliance rules
• Responsible for maintaining patient flow and relationships with physicians and their staff, discussing treatment options, providing nurse and patient education. Act as main point of contact between physician, patient, and Clinical Area Manager (CAM)
• Review new patient referrals and intake information for required documentation and medical necessity, insurance, demographics, clinical history, etc
• Collect and organize medical records, maintain electronic charts including comprehensive care plans, medical information, treatment records and billing data
• Ensure patients have proper authorizations for treatment coverage, perform benefit verification and submission of authorization requests
• Develop payer knowledge base related to diagnosis, coverage guidelines and medical criteria
• Communicate professionally and effectively; requires extreme attention to detail, problem resolution, and knowledge of medical terminology, Protected Patient Info and HIPAA laws
• Develop relationships with patients and providers by maintaining exceptional service and follow up care
• Educate patient on the therapeutic benefits of the SmartVest to promote prescribed adherence
• Discuss therapy and treatment costs, collect, and update necessary patient information and forms for insurance processing
• Assist internal and field team, payers, and patients in understanding payer methodologies and resolution of order-related issues through outreach and response to inquiries
• Effectively submit insurance requests to obtain authorization, utilizing tools such as web portals and authorization partners
• Primary contact for providers & patients prior to the shipment of their device
• Provide order status updates for incoming calls from patients, clinics, and sales representatives
• Initiate and arrange product shipment, including determining device and garment selection
• Quickly and accurately identify and assess individual customer needs, determining appropriate action and taking ownership to ensure positive resolution
• Work closely with referring MD offices and internal team to provide timely service to patients
• Ensure the accuracy of referral and patient data entered into system by verifying information received
• Ensure proper documentation and data is received in a timely manner
• Other duties as assigned

Skills

• High School diploma or GED required
• Substantial experience working directly with providers in healthcare or DME setting
• Strong and solid experience working with insurance companies in the capacity of benefits & coverage, and authorizations
• Previous experience in medical device or other healthcare environments required
• Proficiency working with Microsoft Office suite
• Knowledge of medical terminology
• Familiarity of medical documentation
• Knowledge of Protected Patient Info and HIPAA laws
• Experience with Medicare part B coverage
• Experience with national payers
• Knowledgeable of insurance requirements with the ability to determine medical justification to ensure proper reimbursement
• Strong knowledge of medical insurance benefits and authorization processes
• Degree preferred
• Extensive customer service experience with phone contact, preferably in a call center environment
• Proven and recurring success working directly with sales teams preferred
• Experience with DME billing preferred

Qualifications

Must Haves

• High School diploma or GED required
• Substantial experience working directly with providers in healthcare or DME setting
• Strong and solid experience working with insurance companies in the capacity of benefits & coverage, and authorizations
• Previous experience in medical device or other healthcare environments required
• Proficiency working with Microsoft Office suite
• Knowledge of medical terminology
• Familiarity of medical documentation
• Knowledge of Protected Patient Info and HIPAA laws
• Experience with Medicare part B coverage
• Experience with national payers
• Knowledgeable of insurance requirements with the ability to determine medical justification to ensure proper reimbursement
• Strong knowledge of medical insurance benefits and authorization processes

Nice to Haves

• degree preferred
• Extensive customer service experience with phone contact, preferably in a call center environment
• Proven and recurring success working directly with sales teams preferred
• Experience with DME billing preferred

Benefits

• 6 weeks’ time off annually
• Employee bonus plan
• Flexible hybrid/remote work options
• Full pay maternity, paternity, parental, short-term disability leaves
• Employee driven recognition program
• Access to hundreds of training opportunities
• Company paid educational assistance
• Well-being on demand
• Perks at Work
• Competitive health and welfare plans -HSA company contribution
• 401(k) company match
• Great culture and people!