Infusion Intake Specialist II (31239)

Duties

• Review and process infusion services and physician orders in a timely and accurate manner to obtain payment for infusion services.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Review physician order for Infusion.
• Verify patient benefits independently and with appropriate manufacturer hub programs.
• Determine whether practice can buy & bill or if medication needs to be obtained through a Specialty Pharmacy.
• Absorb patient with foundation copay programs, if eligible for reimbursement program.
• Obtain foundation copay card information once assistance approved.
• Obtain prior-authorization for infusion services from patients insurance company by calling insurance carrier and/or submitting required forms and medical records via fax or online portal.
• If Specialty Pharmacy utilized, submit proper paperwork and patient clinical information.
• Aid in claims payment follow-up involving denials related to authorization or insurance coverage.
• Communicate necessary patient financial information with appropriate office and billing personnel in an efficient, timely and accurate manner.
• Communicate with patient regarding deductibles, copays, co-insurance, and financial assistance coverage.
• Alert supervisor of any roadblocks to timely verification, prior authorizations and payment of infusion claims.
• Provide quality service to patients.
• Abide by all federal, state, and payer requirements and regulations.

Qualifications

• Education: High School Diploma or GED required; associates degree preferred.
• Experience: 3-5 years of prior infusion intake experience is preferred. Prior intake experience related to infusion needed.
• Requirements for Level II Status: Intermediate experience (4+ years experience) and/or acting more independently. Takes on additional duties to assist the office. Strong and consistent performer.
• Performance Requirements: Excellent communication skills, both written and verbal. Excellent customer service skills are required. Proficient computer skills, including MS Office experience, particularly in MS Word and MS Excel. Ability to multi-task and work in a fast-paced environment. Detail-oriented. Strong understanding of healthcare plans. Ability to read and understand medical benefits. Ability to read and understand payer medical policies. Bilingual is a plus. Medical terminology (CPT, ICD 10) knowledge. Self-motivated with initiative. Strong sense of ethics.

Requirements

• Equal Opportunity Employer.
• Committed to creating an inclusive, welcoming, and equitable work environment.
• Firmly believes service is greatly enriched by diversity of thought, experience, perspective, culture, and background.

Notes

• All job offers are contingent on the successful completion of pre-employment criminal history check.
• No phone calls or agencies, please.
• EEO/AA-M/F/disabled/protected veteran.