Intake Specialist

About the role

We are seeking an experienced Intake Specialist to join our team. The Intake Specialist is responsible for receiving and managing referrals from various referral sources in our service areas. The ideal candidate will have a strong background in infusion therapy and be able to provide exceptional customer service to our patients. If you are a detail-oriented individual with a passion for providing exceptional patient care, we encourage you to apply for this exciting opportunity.

Reports to: Departmental Lead, Supervisor or Manager

Job Type: Full-Time, 40 hours per week, Monday - Friday

Location: In office in Madisonville, LA or surrounding areas

Requirements

• High school diploma or GED
• Previous experience working with insurance companies and healthcare professionals (physicians, nurses, etc.) is preferred
• Previous experience with specialty pharmacy patient admissions and customer service in a similar referral source-based practice setting is strongly preferred
• IVIg case management experience preferred
• Must have strong PC skills, especially the MS Office suite
• Previous experience with the pharmacy order processing system, CareTend, is a major advantage (although training will be provided)

Responsibilities

• Obtains initial patient referral admission data and documents
• Directly interfaces with external clients and obtains initial authorization
• Notifies appropriate staff of all pending referrals and patient admissions
• Enters new patient information into the order processing system
• Generates and tracks forms (e.g., LMN, AOB, Consent for Treatment) until all pertinent documentation is received
• Consistently updates patient and clinical information in the order processing system
• Manages patients on the master log every day and forwards to appropriate staff
• Responsible for verifying eligibility and benefits through insurance companies including obtaining prior authorizations and/or pre-determinations
• Communicates in writing or via phone with clients, family members, agents, physicians and discharge planners on eligibility requirements, policy benefits, eligibility determinations and contract provisions
• Proactively researches and resolves issues impacting benefit coverage and revenue optimization
• Performs medical/pharmacy benefit verification requiring complex decision skills based on payer and process knowledge resulting in on boarding or case determined a "no go"
• Contacts benefit providers to gather policy benefits/limitations
• Coordinates and ensures services provided will be reimbursable (e.g., deductible amounts, co-payments, effective date, levels of care, authorization, etc.)
• Communicates with patients regarding Welcome and Financial call information
• Works closely with the billing department for re-authorizations or billing needs, etc.
• Other duties assigned

Physical Demands

• While performing the duties of this job, the employee is regularly required to talk and listen
• The employee is required to occasionally walk, and bend or stand as necessary
• This position requires the ability to occasionally open filing cabinets, lift office products and supplies of 25 pounds but no more than 50 pounds

Benefits

• Competitive Salary
• Medical, Dental, Vision Package
• 401(k) plan (discretionary)
• PTO - Vacation, Sick and Personal days, and paid holidays
• Referral bonuses & Plum Benefits Discount Ticket Program
• Lunch & Learn Programs
• Employee Recognition Program