Infusion Intake Specialist II (32311)

GI Alliance is seeking an experienced Infusion Intake Specialist II to review and process infusion services and physician orders accurately and promptly to ensure payment for infusion services.

Responsibilities

• Review physician orders for infusion.
• Verify patient benefits independently and with appropriate manufacturer hub programs.
• Determine whether the practice can buy & bill or if medication needs to be obtained through a Specialty Pharmacy.
• Assist patients with foundation copay programs, if eligible for reimbursement.
• Obtain foundation copay card information once assistance is approved.
• Obtain prior-authorization for infusion services from patients' insurance companies by calling the carrier and/or submitting required forms and medical records via fax or online portal.
• If a Specialty Pharmacy is utilized, submit proper paperwork and patient clinical information.
• Assist in claims payment follow-up involving denials related to authorization or insurance coverage.
• Communicate necessary patient financial information with appropriate office and billing personnel efficiently, timely, and accurately.
• Communicate with patients 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.
• Perform other duties as assigned.

Qualifications

Education: High School Diploma or GED required; associate's degree preferred.

Experience: 3-5 years of prior infusion intake experience is preferred. Prior intake experience related to infusion is needed.

Requirements for Level II Status

• Intermediate experience (4+ years) and/or acting more independently.
• Takes on additional duties to assist the office.
• Strong and consistent performer.

Skills

• Excellent communication skills, both written and verbal.
• Excellent customer service skills.
• 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.