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medicare regulations for dme and hme companies require this policy if it is applicable to the types of services your dme provides, we make this easy for you with just a small amount of customization, you too will meet the requirements of the federal regulations. this policy is updated to the newest 2010 standards.
POSITION DESCRIPTION / PERFORMANCE EVALUATION Job Title: DME Customer Service Representative Supervised by: Customer Service Supervisor Prepared by: __________________________________ Approved by: ___________________________ Date: ________________________________________ Date: _________________________________ Job Summary: Responsible for receiving all telephone communication from referral sources and customers, including order taking and obtaining accurate billing information, as well as over-the-counter sales; inventory control of office supply levels and ordering; telemarketing; establishing and maintaining files with complete customer information. DUTIES AND RESPONSIBILITIES: E = Exceeds the Standard M = Meets the Standard NI = Needs Improvement Demonstrates Competency in the Following Areas: E M NI Complies with all applicable company policies and procedures. 2 1 0 Ensures that all billing, posting, insurance denials, inquiries, orders, deliveries, service 2 1 0 and pickups are handled in an accurate and timely manner. Screens and directs telephone calls and receives orders from referral sources. 2 1 0 Coordinates all client information and processes paperwork, including preparation of file 2 1 0 for billing department. Establishes customer records and ensures that all client information and records are 2 1 0 current and complete. Verifies insurance eligibility of clients. 2 1 0 Maintains log of referrals. 2 1 0 Assists with implementation of performance improvement program to meet company, 2 1 0 state, federal and JCAHO standards. Performs telemarketing functions as required including, but not limited to, routine calls to 2 1 0 clients and introductory calls to potential referral sources. Assists in resolving customer equipment problems under emergency conditions. 2 1 0 Performs over-the-counter sales functions; handles cash transactions efficiently and 2 1 0 accurately and is able to perform the end-of-the-day cash account balance. Monitors office supply levels and places appropriate orders as approved by customer 2 1 0 service supervisor or operations manager. Develops and maintains working knowledge of current home care products and services 2 1 0 offered by the company and all applicable insurance guidelines regarding eligibility for coverage and reimbursement. Performs all aspects of client care in an environment that optimizes client safety and 2 1 0 reduces the likelihood of medical/health care errors. © The Compliance Doctor, LLC 1 Demonstrates Competency in the Following Areas: E M NI Monitors and records customer, physician and referral source communications. Notifies 2 1 0 appropriate personnel if a particular service or response, within the scope of their responsibilities, is required. Assists Accounts Receivable management. 2 1 0 Processes accounts and maintains appropriate records in a timely manner. 2 1 0 Provides recommendations to callers and walk-in customers regarding supplies and 2 1 0 equipment that can be utilized to meet client’s needs. Secures certificates of medical necessity, with assistance from Marketing Representative 2 1 0 or Clinical Manager. Batches all paperwork daily for submission to the Billing Department. 2 1 0 Professional Requirements: E M NI Adheres to dress code, appearance is neat and clean. 2 1 0 Completes annual education requirements. 2 1 0 Maintains regulatory requirements. 2 1 0 Maintains client confidentiality at all times. 2 1 0 Report to work on time and as scheduled, completes work within designated time. 2 1 0 Wears identification while on duty, uses computerized punch time system correctly. 2 1 0 Attends inservices, as appropriate. 2 1 0 Represents the company in a positive and professional manner in the community. 2 1 0 Actively participates in performance improvement and continuous quality improvement 2 1 0 (CQI) activities. Complies with all organizational policies regarding ethical business practices. 2 1 0 Communicates the mission, ethics and goals of the company. 2 1 0 Total Points ___ ___ ___ © The Compliance Doctor, LLC 2 Regulatory Requirements: Two (2) years experience in insurance office or physician’s office or three (3) years general office experience. High school education required, with minimum two (2) years junior college (all business courses) preferred. Language Skills: Able to communicate effectively in English, both verbally and in writing. Additional languages preferred. Skills: Ability to file, perform accounting functions, maintain records, understand reimbursement requirements and has good typing/computer and telemarketing skills. Knowledgeable in all the major insurance carrier reimbursement guidelines and eligibility for coverage by third party payers. Familiar with all lines of equipment and supplies to meet customer needs. Excellent computer knowledge. Physical Demands: For physical demands of position, including vision, hearing, repetitive motion and environment, see following description. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position without compromising client care. ======================================================================================= I have received, read and understand the Position Description/Performance Evaluation above. Name/Signature Date Signed © The Compliance Doctor, LLC 3 DESCRIPTION OF PHYSICAL DEMANDS JOB TITLE: DEPARTMENT: NAME: # HOURS/WORKDAY: DEVELOPED BY: DATE DEVELOPED: MANAGER SIGNATURE: DATE: CHECK APPROPRIATE BOX FOR EACH OF THE FOLLOWING ITEMS TO BEST DESCRIBE THE EXTENT OF THE SPECIFIC ACTIVITY PERFORMED BY THE STAFF MEMBERS IN THIS POSITION PHYSICAL DEMANDS WORK ENVIRONMENT On-the-job time is spent in the following physical activities This job requires exposure to the following environmental conditions. Show the amount of time by checking the appropriate boxes below. Show the amount of time by checking the appropriate boxes below. Amount of Time Amount of Time None up to 1/3 to 2/3 and None up to 1/3 to 2/3 and 1/3 1/2 more 1/3 1/2 more Stand: Wet, humid conditions (non-weather): Walk: Work near moving mechanical parts: Sit: Fumes or airborne particles: Talk or hear: Toxic or caustic chemicals: Use hands to finger, handle or feel: Outdoor weather conditions: Push/Pull: Extreme cold (non-weather): Stoop, kneel, crouch or crawl: Extreme heat (non-weather): Reach with hands and arms: Risk of electrical shock: Taste or smell: Work with explosives: Risk of radiation: This job requires that weight be lifted or force be exerted. Show how Vibration: much and how often by checking the appropriate boxes below. Amount of Time The typical noise level for the work environment is: Check all that apply. None up to 1/3 to 2/3 and Very Quiet Loud Noise 1/3 1/2 more Quiet Very Loud Noise Up to 10 pounds: Moderate Noise Up to 25 pounds: Up to 50 pounds: Hearing: Up to 100 pounds: Ability to hear alarms on equipment More than 100 pounds: Ability to hear client call Ability to hear instructions from physician/department staff This job has special vision requirements. Check all that apply. REPETITIVE MOTION ACTIONS Close Vision (clear vision at 20 inches or less) Number of Hours Distance Vision (clear vision at 20 feet or more) Repetitive use of foot control 0 1-2 3-4 5-6 7+ Color Vision (ability to identify and distinguish colors) A. Right only Peripheral Vision (ability to observe an area that can B. Left Only be seen up and down or to the left and right while C. Both eyes are fixed on a given point) Depth Perception (three-dimensional vision; ability Repetitive use of hands to judge distances and spatial relationships) A. Right only Ability to Adjust Focus (ability to adjust eye to B. Left Only bring an object into sharp focus) C. Both No Special Vision Requirements Grasping: simple/light A. Right only Specific demands not listed: ________________________________ B. Left Only _______________________________________________________ C. Both _______________________________________________________ Grasping: firm/heavy _______________________________________________________ A. Right only _______________________________________________________ B. Left Only _______________________________________________________ C. Both Fine Dexterity Note: Reasonable accommodations may be made to enable individuals A. Right only with disabilities to perform the essential functions of this position. B. Left Only C. Both © The Compliance Doctor, LLC 4 PERFORMANCE EVALUATION CONTINUATION PAGE Staff Member: Job Title: Performance Evaluation Score: # of total points achieved 80 - 100% exceeds standards 50 - 79% meets standards _________________________ X 100 = _________% 0 - 49% needs improvement (# questions x 2) Manager’s Comments: Recommended Goals/Actions: Staff Member Comments: Actions Recommended by Department Manager: Performance Review Only Salary Increase: _____________ Next Performance Review on: _____________ Salary Increase Denied ____________________________________________ __________________________ Staff Member Signature Date ____________________________________________ __________________________ Department Manager Signature Date ____________________________________________ __________________________ Administrative Signature Date © The Compliance Doctor, LLC 5 PERSONNEL MEMBER ANNUAL PROFESSIONAL PERFORMANCE AND COMPETENCY EVALUATION As a member of the Company’s personnel team, your comments and input are important to both the continuing development and quality provision of client care and services of the institution. Your continued professional growth and job satisfaction are primary goals of the organization. The administrative team and your department supervisor are interested in your comments regarding the following: 1 - 5 (1 = poor, 5 = excellent) 1. How would you rate your current job satisfaction level? 2. How would you rate your current job performance? 3. How would you rate the organization’s provision of personnel benefits? 4. How would you rate the organization’s provisions for personnel continuing education? 5. How would you rate the organization’s physical working environment? 6. How would you rate the organization’s emotional working environment? 7. List your professional goals: 8. List any departmental goals that may differ from professional goals (include educational and performance goals): 9. Is there anything the organization can do to help you achieve any of these goals? 10. If so, please describe: 11. Comments you feel may assist the organization with improving personnel satisfaction levels: Note: This organization pledges to utilize information provided for the sole purpose of improving personnel satisfaction and assisting the author with achievement of advanced personal and/or professional growth. © The Compliance Doctor, LLC 6
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