After Hours Patient Service Representative

Position Summary:

Highly skilled professional who provides customer service and support to patients during evening, overnight, and weekend hours. Serves as the primary point of contact for patients seeking assistance outside of normal business hours, handling inquiries, scheduling appointments, and providing support for patient needs.

Essential Functions and Job Responsibilities: 

Patient Communication & Support

• Delivers exceptional customer service with empathy, patience, and professionalism across all communication channels
• Answers incoming calls and emails from patients during after-hours periods, responding promptly and accurately
• Serves as primary contact for complex patient and referral source inquiries
• Triages service needs and troubleshoots issues for patients, caregivers, and referral sources
• Connects patients with on-call staff or leadership when clinically necessary
• Handles patient complaints and escalated concerns professionally
• Demonstrates emotional intelligence when managing sensitive patient situations

Administrative Duties

• Schedules and reschedules patient appointments and services for upcoming business days
• Verifies patient insurance information, DME benefits coverage, and processes prior authorizations
• Updates patient demographic and contact information in electronic health records with precision
• Processes prescription refill requests and relays to appropriate pharmacy or provider
• Handles DME equipment inquiries, authorization requests, and order processing
• Manages billing inquiries, payment processing, and processes returns
• Maintains accurate documentation of all patient interactions and referral information
• Supports referral intake processes and ensures documentation accuracy
• Collaborates with Intake, Clinical, and Operations teams for seamless service delivery

Emergency Protocol Management

• Follows established procedures for emergency situations, equipment needs, and critical care support
• Escalates urgent matters to on-call staff or leadership as appropriate
• Provides patients with instructions for immediate care and emergency equipment needs
• Documents emergency calls and critical situations for provider review
• Supports critical after-hours program functions for patients requiring immediate assistance

System & Technology Management

• Operates internal systems and software tools including Microsoft Office, EMRs, and referral management platforms
• Navigates multiple computer systems including EHR, scheduling, and billing platforms
• Maintains proficiency in call center technology and phone systems
• Generates reports and maintains call logs as required
• Ensures HIPAA compliance and strict adherence to company policies in all patient interactions
• Multitasks and prioritizes multiple calls and tasks simultaneously while maintaining service standards
• Maintains patient confidentiality and functions within the guidelines of HIPAA.
• Completes assigned compliance training and other education programs as required.
• Maintains compliance with AdaptHealth's Compliance Program.
• Performs other related duties as assigned.

Competency, Skills and Abilities: 

• Advanced knowledge of medical terminology and DME equipment classifications
• Knowledge of DME billing codes and insurance authorization processes
• Strong understanding of oxygen (O2) services, DME, and insurance processes including prior authorizations and coverage guidelines
• Familiarity with ACT, Vent, Negative Pressure Wound Therapy (NPWT), and full range of DME products
• Exceptional customer service with clear and effective verbal and written communication skills
• Strong problem-solving and analytical thinking abilities to assess situations and implement solutions quickly
• Enhanced attention to detail and accuracy in documentation and data verification
• Ability to remain calm and professional under pressure while managing sensitive situations
• Multitasking and prioritization skills in fast-paced environment
• Patient-focused approach with emotional intelligence and empathy
• Adaptability and flexibility to adjust to changing processes, technologies, and patient needs
• Independence and initiative to complete tasks with minimal supervision
• Team collaboration skills to work cooperatively across departments
• Commitment to continued learning and professional development
• Ability to work with diverse patient populations and referral sources

Education & Experience

• High school diploma or equivalent required
• Associate’s degree in healthcare administration, Business Administration, or related field preferred
• Minimum 1-2 years customer service experience, healthcare setting preferred or call center experience
• Minimum 3 years of DME (Durable Medical Equipment) healthcare experience required
• Previous experience in healthcare, insurance, medical billing, or patient services preferred.

Preferred Qualification

• Healthcare or medical office experience beyond DME
• Bilingual capabilities
• Customer service or healthcare administration certification
• Experience with ACT, Vent, NPWT, and specialized DME equipment
• Advanced knowledge of insurance verification and prior authorization processes
• Medical scheduling systems experience
• Experience working in after-hours or call center environments
• Leadership or training experience in healthcare settings