[Hiring] Home Infusion Intake Coordinator @AIS Healthcare

Role Description Advanced Infusion Care is looking for an experienced and motivated Intake Coordinator to join our dynamic team! The Intake Coordinator role is a full-time position responsible for providing patient access to the medication and therapies needed by contacting insurance companies and verifying the patient’s health insurance eligibility, benefits, coverage/non-coverage information and initiation/extension of authorizations.

• Home Infusion experience required - IG / Specialty products preferred.
• The perfect candidate should have outstanding communication and time management skills.
• Extreme attention to detail and accuracy is essential.
• In-depth knowledge of insurance benefit verification is required.
• Work in compliance with Federal and State rules and regulations.

Qualifications

• A high school diploma or general education degree (GED) equivalent is required.
• Minimum 2 years’ experience in customer service, medical billing and coding, benefits verification, healthcare, or similar vocations.
• Specifically seeking experience with California payers.

Requirements

• Enter all required demographic, physician, insurance, authorization, and other information into a profile for all new patients.
• Review all incoming faxed prescription orders and attach to new or existing patient profile.
• Contact patient or physician to fill in any missing information.
• Conduct comprehensive benefit investigation for new patient referrals.
• Obtain clinical, lab, and medical testing documentation from physicians’ offices for submission of prior authorization.
• Perform timely follow up on authorizations through the process until approved.
• Communicate with patients, physicians, and other departments on benefits and the status of authorization requests.
• Communicate denials to physicians’ offices and provide follow up details on the peer to peer or appeal options.
• Regularly communicate the status of the intake process to other departments, including Nursing, Pharmacy and Sales.
• Notify patients/families/referral sources regarding coverage and payment responsibilities as necessary.
• Provide explanation and paperwork for Care Support Program to patients who express financial hardship.
• Document in the patient’s clinical record progress notes, all requests and conversations for the purposes of seamless coordination of care.
• Identify in-network or mandated pharmacy providers if unable to service a patient due to insurance constraints.
• Provide leadership, oversight, and technical guidance to associates, and assist to resolve difficult cases.
• Train new associates.
• Suggest and develop documentation to standardize workflow process changes and submit for approval.
• Participate in any variety of meetings and work groups to integrate activities, communicate issues, obtain approvals, resolve problems and maintain specified level of knowledge.
• Train new and existing associates in the use of pharmacy software system, supplemental applications, customer service techniques, job responsibilities, and departmental workflow.
• Identify deviations from training and/or processes during normal work activity.
• Serve as the SME for new applications, software upgrades, work queues, accuracy and other related processes.
• Promote training participation and coach associates in following new and existing workflow processes.
• Comply with and adhere to all regulatory compliance areas, policies and procedures and company “best practices”.
• Responsible for adhering to the quality, production, and turnaround standards associated with the department and/or assigned program.
• Other duties as assigned.

Benefits

• Health, vision, and dental insurance.
• Long term disability insurance.
• Life insurance.
• Vacation package.
• 401K plan with a generous employer match.
• Remote work from home opportunity.
• Growth opportunities.

Steps to Apply To apply for this role, you must complete a Culture Index Assessment to be considered. Please note that your application will not be considered if the Assessment is not completed. Copy and paste the following link into your browser and press enter. Then, select the corresponding position for which you are applying. (Only one assessment per candidate is required.) The assessment is brief, taking less than ten minutes to complete. Culture Index Assessment Apply tot his job Apply To this Job