CSR II - Home Health Intake Processor (DME) - (Part-time Weekends)

Education: Some college preferred

Licenses/Certifications: (None)

Experience / Knowledge / Skills:

• Three (3) years Customer Service or Claims processing experience in a TPA or HMO environment

• Bilingual preferred

Principal  Accountabilities

• Efficiently and courteously responds to telephone inquiries from subscribers regarding benefit verification, claims issues, and eligibility.

• Interprets plan coverage for subscribers and providers to determine correct level of benefit coverage.

• Provides claim filing instructions when needed to subscribers and providers.

• Provides telephone assistance to subscribers and providers, and verifies eligibility as required.

• Promptly returns phone calls resulting from inquiries that require additional research.

• Efficiently enters data simultaneously while listening attentively.

• Provides a high degree of confidentiality/discretion and independent judgment.

• Keeps workstations stocked and organized at all times.

• Performs daily clerical duties, including sending faxes, making copies, and assisting in other areas.

• Efficiently makes requested changes (temporary address changes, ID card requests).

• Ensures safe care to patients, staff and visitors, adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.

• Promotes individual professional growth and development by meeting requirements for mandatory/continuing education, skills competency, supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor, and resource to less experienced staff.

• Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models Memorial Hermann’s service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.

• Other duties as assigned.