PromptCare

Reimbursement Specialist

• Handle all patient billing and collections
• Collect third-party payor accounts for assigned payers
• Follow up on revenue-cycle reimbursement matters, including projects, issue escalation, denials management and research
• Maintain and update shared documentation on insurance policies, rules and limitations
• Identify adjustments, payment trends and denials and escalate problems as necessary
• Communicate changes regularly or as needed
• Collaborate with Intake and Reauthorization Specialists to ensure timely collections
• Assist the PBM and Billing Specialist with issues, billing backlogs and end-of-month processes
• Field and troubleshoot patient calls regarding benefits, claims and balances
• Proactively resolve billing issues
• Perform CPR+/Caretend transactions accurately and timely
• Document and input new referrals and subsequent patient admissions from start to finish according to PromptCare policies and procedures
• Perform other duties as assigned

Authorization Specialist

• Submit initial authorization requests to assigned payers using paper forms, printed documentation, fax, payer portals, or other means
• Follow up on requests to ensure timely turnaround and approval
• Understand payer requirements to ensure approval is granted
• Escalate problem accounts and ensure resolution
• Maintain regular contact with patients, insurance plans, physician offices, sales representatives, and other personnel
• Submit authorization requests to insurance payers for Home Infusion Therapy
• Oversee follow-up on pending authorizations
• Review authorization approvals and denials for accuracy and initiate the appeal process
• Document calls, faxes, and email communications in CPR+ according to department SOP
• Maintain records of approved and denied authorizations in patients’ charts
• Share insurance updates and communications with management and team members
• Perform other duties assigned by the Intake Manager

• Handle all patient billing and collections
• Complete documentation and computer input for new referrals and subsequent patient admissions from start to finish
• Collect third-party payor accounts for assigned payers
• Follow up on revenue cycle reimbursement activities, including projects, issue escalation, denials management, and research
• Maintain and update shared documentation for the Intake Team regarding insurance policies, rules, and limitations
• Identify adjustments, payment trends, and denials and escalate problems as necessary
• Communicate changes regularly or as needed
• Collaborate with Intake and Reauthorization Specialists to ensure timely collections
• Assist the PBM and Billing Specialist with issues, billing backlogs, and end-of-month processes
• Handle and troubleshoot patient calls regarding benefits, claims, and patient balances
• Proactively resolve billing issues
• Perform CPR+/Caretend transactions accurately and timely
• Perform other duties as assigned

Account Executive

• Drive sales of respiratory products and services to healthcare providers and institutions
• Increase referrals through promotion of core services to referral sources
• Meet or exceed budgeted goals through focused business initiatives
• Mentor the team of Clinical Respiratory Liaisons
• Support the Director of Sales with development and implementation of Clinical Programs and best practices in the assigned market
• Evaluate referral-source satisfaction and develop branch opportunities to improve customer satisfaction
• Initiate and develop relationships with referral sources and physicians to increase referrals
• Assess accounts for new business opportunities and promote new company services
• Utilize internal and external resources to increase profitable net revenues and meet budget objectives
• Secure renewal orders with existing customers
• Follow up regularly with accounts regarding satisfaction, changing needs, territory strategies, sales-goal progress, product mix, payor mix, and market penetration
• Initiate and coordinate in-services with clients and appropriate managers
• Identify and establish relationships with referral decision-makers
• Develop and implement a territory marketing plan consistent with company goals and regulatory and accrediting requirements
• Assist in developing new programs aligned with plans, client needs, and community demand
• Prepare materials for sales calls, presentations, and promotions
• Meet monthly quota objectives
• Perform other duties as assigned
• Communicate verbally, listen attentively, lift files, open filing cabinets, and bend or stand as needed