Patient Services Representative, Authorizations - ADVANCED OXYGEN THERAPY INC.

AOTI is the global leader in multimodality topical wound oxygen therapy. Our patented non-invasive Topical Wound Oxygen (TWO2) therapy is the only device that has demonstrated in Randomized Controlled Trial (RCT) and Real-World Evidence (RWE) studies to heal Diabetic Foot Ulcers (DFUs), resulting in an unprecedented 88 percent reduction in hospitalizations and 71 percent reduction in amputations over 12 months – because of this and more, AOTI is growing fast!

The Patient Services Representative, Authorizations is responsible for obtaining prior authorizations for all procedural orders by successfully completing the authorization process with all payers.

General Accountabilities

• Ensure all insurance, demographic, and eligibility information is obtained and entered into the system(s) in an accurate manner.
• Perform insurance verification process.
• Obtain initial and subsequent pre-authorization for services.
• Ensure appropriate signatures are obtained on all necessary forms.

• Regular authorizations follow-up to obtain insurance determinations in a timely manner.
• Processing prior authorizations and authorization appeals as necessary.
• Provide customer service support and build relationships with wound care consultants and other teammates.
• Dispatch set-ups, pick-ups, and other tasks to field teammates.
• Reviewing claims for accuracy before submission.

• Schedule oxygen concentrator and controller set up and delivery as well as product shipments.
• Medical coding and billing for all third party and direct claims.

• Maintain accurate data and reference data in GoCanvas, third-party billing, and in-house ERP systems.
• Help train new hires on process and procedures within the department.
• Maintain training tools and develop new training tools as needed.
• Cross-trained in collections to follow up on unpaid claims.
• Demonstrate an understanding of patient confidentiality to protect the patient and corporation.
• Responds in a timely manner to all inquiries from customers, sales reps, and co-workers.
• Assists and communicates with all departments to help increase efficiency and accuracy.
• Performs all other duties assigned  

Job Qualifications

• High School diploma or equivalent required, Bachelors in related field preferred.
• Position requires at least 3 years of medical office/provider/billing/collections work experience with insurance procedures.
• Must have excellent communication skills, written and verbal. Proficiency with computer, internet and Microsoft Office (Outlook, Word, and Excel).
• Problem Solving - Identifies and resolves problems time efficiently; Gathers and analyzes information; Develops solutions; Uses reason. 

Physical Demands

• Occasionally required to sit.
• Occasionally required to walk.
• Occasionally required to use hands to finger, handle, or feel.
• Occasionally required to reach with hands and arms.
• Occasionally required to talk or hear.
• Occasionally required to bend, lift or climb.
• Occasionally required to lift light weights (less than 25 pounds).
• Occasionally required to lift moderate weights (25-50 pounds).
• Finger dexterity required.
• Hand coordination required.

 Work Environment

• Possible risk of electrical shock.
• The noise level in the work environment usually is speaking level.