PAP Customer Service & Resupply Expert

Overview
We are seeking a dedicated and detail-oriented PAP Customer Service and Resupply Expert to join our team. This role is crucial to insure that patient documentation (sleep studies, physician orders, labs, compliance data, etc.) meets payor qualifications and compliance (Medicare, Medicaid and commercial payors) as well as verifying benefits, obtaining auths where necessary and scheduling deliveries. Interaction with EPIC and TeamDME! is a big plus. The ideal candidate will possess strong organizational skills, attention to detail, and a commitment to providing excellent customer service.

Duties

• Manage the incoming documentation for qualification and compliance with Federal, State and commercial payors along with verifying insurance benefits and coverage details.
• Maintain accurate and up-to-date patient records and documentation related to PAP usage and supply needs.
• Obtaining prior authorizations and maintaining authorizations with commercial payers via their respective web portals.
• Review labs, chart documentation and compliance data for continued use for all payer sources (Federal, State and commercial payers).
• Coordinate supply orders for both new, existing and transferring patients.

Requirements

• Minimum of at least 3 years of PAP customer service, documentation and compliance experience in the Durable Medical Equipment (DME) environment is REQUIRED.
• Strong organizational skills with the ability to manage multiple tasks simultaneously.
• Excellent communication skills, both verbal and written, to interact with healthcare and insurance professionals effectively.
• Familiarity with medical documentation practices and patient confidentiality regulations (HIPAA).
• Proficiency in using computer systems for data entry and record management. Specifically, use of HME software. TeamDME! and EPIC experience are a big plus!
• Ability to work independently in a fast-paced environment is a must.
• Applicant MUST be able to pass CRIMINAL, SEX OFFENDER and OIG EXCLUSION background checks.
• Hours are 8:30AM to 5:00PM Central Standard Time.

Job Type: Full-time

Pay: $18.00 - $20.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Flexible schedule
• Health insurance
• Paid time off

Application Question(s):

• Are you able to pass a criminal background check, sex offender background check and OIG exclusion check as required for this position? YES or NO.
• Do you have 3+ years of PAP customer service and resupply activity for a Home Medical Company reviewing documentation, labs and ensuring compliance with payer requirements? PLEASE DESCRIBE.
• Do you have 3+ years of experience obtaining prior authorizations and maintaining authorizations for PAP? PLEASE DESCRIBE.
• Please describe Medicare’s specific compliance requirements for continued PAP usage after the patient’s initial 90 day trial period.

Work Location: Remote