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Order Intake Quality Advocate Lead

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Job Type: Full-Time
Category: Medical Billing
Location: Plano, TX, United States
Date Posted:

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Description

Job Summary:

The Order Intake Quality Advocate works within the Order Intake Business Unit and is the key individual responsible for reviewing orders submitted by the Sales department to ensure they follow all applicable accreditation, compliance/regulatory processes, Inogen policy, and Payor guidelines. This includes a review of the appropriate patient file within database systems, medical documentation, payment information, and patient supplied documents.

Responsibilities (Specific tasks, duties, essential functions of the job)

Order Intake Quality Advocate I

  • Conduct internal order reviews from various Inogen teams, or via online order requests, to ensure all documentation required for order type are attached, accurate, and acceptable per Inogen’s policies and procedures.
  • Make recommendations to improve quality, workflow processes, policies and procedures to enhance the order review process by decreasing processing time and increasing quality.
  • Manage multiple work lists and responsibilities by monitoring volumes and aging, while collaborating with teammates to maintain required SLAs and performance metrics, with appropriate attention to detail and quality standards.
  • Provide constructive feedback for order rejections when files are found to be unacceptable.
  • Process requests for order corrections or reviews
  • Follows HIPAA and company standards while interacting with patients, doctors, and other staff by practicing the highest level of support. This may include inbound or outbound calls, as well as processing credit card payments.
  • Ensures Inogen’s compliance with all state and federal regulations.
  • Ensures that appropriate medical records are maintained according to HIPAA guidelines.
  • Maintain regular and punctual attendance.
  • Comply with all company policies and procedures.
  • Assist with any other duties as assigned.

Order Intake Quality Advocate II

In addition to items listed for Order Intake Quality Advocate I, an Order Intake Quality Advocate II may also be responsible for the following.

  • Performs quality assurance reviews of team member’s files and provides feedback as appropriate.
  • Assists in handling disputes, escalations, and complex issues in an appropriate and timely manner.
  • Participates in training new employees as well as recurrent training for existing employees.
  • Utilizes subject matter expertise to resolve complex technical and business processes and responsibilities.
  • Collaborates to develop and improve work instructions, workflows, and learning aids for continuous team growth.
  • Runs daily/weekly reporting to track any non-booked orders, productivity, rejection trends, or other team function reporting.
  • Participates in high level projects and various assignments as required.
  • Demonstrates leadership skills by maintaining professional outlook and positive attitude

Order Intake Quality Advocate Team Lead

In addition to items listed for Order Intake Quality Advocate II, an Order Intake Quality Advocate Team Lead may also be responsible for the following.

  • Ensure claims will be billable based on order type, benefit payment, contract interpretation, and in compliance with policies and procedures.
  • Make recommendations to improve quality, workflow processes, policies and procedures to enhance the order review process by decreasing processing time and increasing quality.
  • Manages processing of requests for order corrections or reviews, including daily KPI and Metrics reporting.
  • Monitors call handling metrics and standards to ensure customer support and customer satisfaction.
  • Responsible for handling complex issues and de-escalating patient calls.
  • Ensures the team follows HIPAA and company standards while interacting with patients, doctors, and other staff by practicing the highest level of support. This may include inbound or outbound calls, as well as processing credit card payments.
  • Assists in resolving complex technical and business processes and responsibilities.
  • Responsible for daily/weekly reporting to track any non-booked orders, productivity, rejection trends, or other team function reporting.
  • Participates in high level projects and various assignments as required.

Knowledge, Skills, and Abilities

  • Excellent verbal and written communication skills required.
  • Must possess good time management skills, with the ability to prioritize and multi-task.
  • Must be detail-oriented and analytical to ensure documentation is being assessed properly.
  • Experience with CRM platforms, preferably Salesforce, Oracle, and/or Brightree preferred.
  • Work experience or knowledge of the healthcare industry, preferably specific to Medicare or prescription guidelines.

Qualifications (Experience and Education)

Level I

Order Intake Quality Advocate I

· High School diploma or equivalent, required.

· 1-3 years of experience reviewing documentation for Medicare Oxygen/DME Billing, Insurance Billing, or prescription requirements, required.

· Experience working with Medical Sales personnel, preferred

· Intermediate knowledge/proficiency in Microsoft Office, required.

· A combination of training, education and experience that is equivalent to the qualifications listed above and that provides the required knowledge, skills, and abilities.

Level II

Order Intake Quality Advocate II

· Associates degree in Communications, Healthcare Management or related field, preferred.

· Minimum of 3 years of experience reviewing documentation for Medicare Oxygen/DME Billing, Insurance Billing, or prescription requirements, required.

· Experience working with Medical Sales personnel, required.

· Intermediate knowledge/proficiency in Microsoft Office, required.

· A combination of training, education and experience that is equivalent to the qualifications listed above and that provides the required knowledge, skills, and abilities.

Level III

Order Intake Quality Advocate Team Lead

· Associates degree in Communications, Healthcare Management or related field, preferred.

· 3+ years’ of Medicare and Insurance Billing or Intake (preferably for oxygen or HME billing), required

· 2+ years customer service experience, required.

· Intermediate knowledge/proficiency in Microsoft Office, required.

· 2+ years de-escalation and quality assurance, preferred.

· 1+ years’ experience working with Medical Sales personnel, preferred

· A combination of training, education and experience that is equivalent to the qualifications listed above and that provides the required knowledge, skills, and abilities.

Disclaimer

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.



Physical Job Demands

Job Classification/Family – Administrative

The physical job demands are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Frequency Code: The following abbreviations denote the frequency an activity is performed daily.

N = Never (0 hours)

O = Occasionally (>0 hours and <3 hours)

F = Frequently (<3 Hours and <5 hours)

C = Continuously (>5 hours)

Physical Demands

Frequency of demands during Essential functions

Code

Code

Code

Sitting

C

Kneeling

N

Carrying

O

Standing

O

Crawling

N

Reaching:

O

Walking

O

Climbing

N

Above Shoulders

O

Bending

O

Balancing

N

At/Below Shoulders

O

Stooping

O

Finger movement (repetitive)

C

Oral communication, clear speech

C

Squatting

O

Pushing

N

Seeing (far/near)

C

 

Pulling

N

Hearing acuity

C

Object Manipulation

Code

Fine Manipulation

C

e.g., writing, typing, picking up a paper clip, page turning

Simple Grasp

O

e.g.; turning a doorknob, picking up an object <5 lbs., phone

Firm Grasp

O

e.g., Lifting and handling objects >5 lbs.

 

Lifting

Weights/Pounds

Below Waist

Waist/ Chest

Above Shoulder

Examples of Objects

Up to 10

O

O

O

Office supplies, laptop, ream of paper

11-25

O

O

O

Box of material, supplies

26-50

O

O

N

Box of material

51-75

N

N

N

76-100

N

N

N

Over 100

 

 

 

May be exposed to the following conditions:

Environmental Conditions

Indoor, electrical hazards, slippery surfaces, travel to other Inogen facilities, potential ergonomic hazards

Safety equipment/attire

Clerical equipment

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