Intake Specialist

We are seeking an experienced Intake Specialist to join our team, focusing on receiving and managing referrals from various sources in our service areas. The ideal candidate will have a strong background in infusion therapy and a commitment to exceptional customer service and patient care.

Reports to: Departmental Lead, Supervisor, or Manager
Location: Hybrid, out of either New Providence, NJ or Lenexa, KS

Responsibilities

• Obtains initial patient referral admission data and documents.
• Directly interfaces with external clients to obtain 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 daily and forwards to appropriate staff.
• Verifies 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 onboarding or case determination as 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.
• Performs other duties as assigned.

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.
• Strong PC skills, especially in the MS Office suite.
• Previous experience with the pharmacy order processing system, CPR+, is a major advantage (training will be provided).

Physical Demands

• Regularly required to talk and listen.
• Occasionally required to walk, bend, or stand as necessary.
• Ability to occasionally open filing cabinets and lift office products and supplies up to 25 pounds (no more than 50 pounds).

Benefits

• Comprehensive Medical, Dental, and Vision Package.
• 401(k) Plan with Company Match.
• Generous PTO: Vacation, Sick Time, Personal Days, and Paid Holidays.
• Life Insurance: Standard coverage with optional enhancements.
• Employee Assistance Program: Free counseling and coaching sessions.
• Emotional Well-being and Work-Life Balance Resources.
• Short & Long-Term Disability: Company-paid with optional supplements.
• Accidental Death and Dismemberment Insurance.
• FSA and HSA: Manage healthcare expenses.
• Commuter Spending Programs.
• Volunteer and Engagement Opportunities.
• Employee Referral Bonuses.
• Exclusive Discounts on entertainment, travel, and various other supplemental and cellphone plans.

Schedule

Full-Time, 40 hours per week, Monday - Friday.