Summary: The Patient Care Associate is responsible for the administrative and back-office functions that support patient care and DMEPOS operations. This role focuses on insuranceverification, reimbursement processing, documentation management, and coordination with referral sources and physicians. The associate ensures accuracy and compliance in billing andrecordkeeping while supporting the operational workflow of the organization.
Responsibilities and Duties:
• Verify private insurance, Medicare, and Medicaid coverage, ensuring compliance withbilling requirements.
• Process patient intake forms and required documentation for product or service delivery.
• Maintain complete and accurate patient records for billing and reimbursement purposes.
• Prepare invoices, route delivery documentation, and monthly financial/operationalreports.
• Process and track reimbursement claims (manual or electronic) in accordance withcompany policy.
• Maintain rental files, including Medicaid coverage verification and monthly follow-up onpending patients.
• Input and manage data across multiple systems; generate orders, invoices, statements, andreports.
• Communicate with physicians’ offices and referral sources to obtain authorizations, prescriptions, and supporting documentation.
• Identify and escalate issues that could affect timely or accurate reimbursement to theOperations Director.
• Assist with driver route planning and back-office support for daily deliveries.
• Participate in in-service trainings and compliance meetings to remain current onregulations.• Perform additional administrative duties as assigned.
Qualifications:
• Education: High school diploma or equivalent.
• Experience/Skills:
o Prior experience in medical billing, insurance processing, or healthcareadministration preferred.
o Proficient in data entry and computer systems; detail-oriented with strongorganizational skills.
o Strong written and verbal communication skills for coordination with internalteams and referral sources.
Physical Requirements:
• Ability to remain seated and perform computer-based tasks for extended periods.
• Ability to lift up to 15 lbs. occasionally for filing or record management.
Training & Compliance Requirements:
• Ongoing training in HIPAA, infection control, Medicare billing compliance, fraudprevention, and documentation standards.
• Satisfactory completion of annual performance evaluations and compliance updates.
