Intake Coordinator

About the role

The Intake Coordinator acts as a liaison between the referral source and the Pharmacy to ensure a seamless transition from the acute care setting to home care for patients. This role establishes and maintains relationships with referral sources by receiving and processing intake information for potential patients who require home infusion therapy.

Responsibilities

• Facilitate the intake process by procuring all patient information necessary to determine home infusion admission based on supportive clinical data, prescribed therapy, assignment of home infusion benefits, and adherence to patient acceptance criteria policies and procedures.
• Identify participating payers and contractual pricing agreements.
• Verify health insurance coverage using verification forms, inquire about case management, obtain authorization numbers, and maintain pre-certification.
• Perform case management updates for changes in therapy and patient status.
• Once verification is complete and admission criteria are reviewed/approved by clinical staff, contact the referral source to notify them of acceptance or denial of the referral.
• Coordinate the discharge plan with the referral source, discharge planner, nursing agency (when applicable), pharmacy, and patient/caregiver as needed.
• Establish relationships with licensed and certified nursing agencies to provide clinical nursing services to pharmacy patients.
• Notify the patient or approved patient advocate and explain their financial responsibilities.
• Complete all applicable sections of Intake and Confirmation forms and enter data into CPR+.
• Negotiate pricing with case management under the direct supervision of the Center Manager.
• Assist with the creation and maintenance of Medicare CMNs.
• Obtain and track authorizations.
• Complete monthly re-verification of Medicaid recipients.
• Document credit and cash co-payments made at the location level.
• Obtain clinical documentation necessary for billing.
• Handle the intake of personal referrals.
• Perform data entry and update patients' demographic information.
• Conduct insurance benefit verification and coordinate with nursing and pharmacy staff.
• Prepare and manage paperwork and documentation for billing and collections.
• Resolve patient/payee issues in a timely manner.