Order Intake Quality Advocate Lead

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)

• 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.
• Follow 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.
• Ensure Inogen’s compliance with all state and federal regulations.
• Ensure that appropriate medical records are maintained according to HIPAA guidelines.
• Perform quality assurance reviews of team member’s files and provide feedback as appropriate.
• Assist in handling disputes, escalations, and complex issues in an appropriate and timely manner.
• Participate in training new employees as well as recurrent training for existing employees.
• Utilize subject matter expertise to resolve complex technical and business processes and responsibilities.
• Collaborate to develop and improve work instructions, workflows, and learning aids for continuous team growth.
• Run daily/weekly reporting to track any non-booked orders, productivity, rejection trends, or other team function reporting.
• Participate in high level projects and various assignments as required.
• Demonstrate leadership skills by maintaining professional outlook and positive attitude.
• 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.
• Manage processing of requests for order corrections or reviews, including daily KPI and Metrics reporting.
• Monitor call handling metrics and standards to ensure customer support and customer satisfaction.
• Responsible for handling complex issues and de-escalating patient calls.
• Ensure 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.
• Assist 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.
• Participate in high level projects and various assignments as required.
• Maintain regular and punctual attendance.
• Comply with all company policies and procedures.
• Assist with any other duties as assigned.

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)

• 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.