Patient Account Liaison

About the position The Patient Account Liaison (PAL) is responsible for reviewing and processing new referrals from patient intake to shipping and insurance approval. The PAL is the primary contact for patients, clinics, and Clinical Area Managers within their designated territory with responsibilities including patient intake and contact throughout the referral process, obtaining payer required documentation, submitting, and obtaining insurance authorizations, obtaining patient documents, and assisting with patient payment programs. This is a fulltime remote position.

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

Requirements

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

Benefits

• 6 weeks time off annually
• Incentive 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!

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