Suspended Billing Representative - Full-time

Description


Apria Healthcare is one of the nation's leading providers of home respiratory services and certain medical equipment, including oxygen therapy, inhalation therapies, sleep apnea treatment and negative pressure wound therapy. Headquartered in Lake Forest, California, Apria owns and operates more than 400 locations throughout the United States and serves more than 1.2 million patients each year. Apria was the first such company to obtain voluntary accreditation from The Joint Commission and has been continuously accredited for more than 25 years. Additional company information can be found at www.apria.com .

• Performs follow-up on outstanding Certificates of Medical Necessity (CMNs), prescriptions and processes renewal CMNs/prescriptions through the use of suspended billing reports. Maintains and monitors follow up system to confirm that action takes place per Apria "best practices".
• Performs timely follow-up on renewal authorizations to maintain reimbursement activity.
• Contacts patient to gain involvement in problematic situations.
• Elevates aged prescriptions to manager for decision and resolution.
• Evaluates all completed CMNs/prescriptions/authorizations to ensure that the appropriate information has been obtained to allow for reimbursement as well as compliance with applicable standards and regulations.
• Enters CMNs/prescription information into computer once the prescriptions are completed and returned from the physicians.
• Documents all account activity on system. May perform internal quality audits to ensure that all necessary documentation is included in each patient file.
• Processes, reviews and mails prescription and/or CMNs to physicians for signature.
• Provides feedback on errors identified to the appropriate supervisor through the use of the ENF process or other accepted method.
• Researches diagnosis and insurance benefits to receive proper reimbursement.
• Assists in obtaining authorization for reimbursement for some accounts.
• Requests adjustments on accounts and recommends necessary changes to supervisor.
• Complies with and adheres to all regulatory compliance areas, policies and procedures and "best practices".
• Performs other related duties as directed by supervisor.

Qualifications

• High school diploma or GED is required.
• At least one year related experience is required.

Apria Healthcare is an equal opportunity employer. All employment decisions are made without regard to race, color, age, gender, gender identity or expression, sexual orientation, marital status, pregnancy, religion, citizenship, national origin/ancestry, physical/mental disabilities, military status or any other basis prohibited by law.
Because Apria believes in providing a safe work environment, we conduct drug and background checks in our recruiting/hiring processes. AA/EOE, M/F/D/V