Lead Specialty Intake Patient Access Specialist - Remote

Cyber Focus AI's mission is to help cybersecurity professionals discover cutting-edge opportunities in their field. Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best.

About the role

You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. The Senior Intake Specialist is responsible for receiving referrals from sources and ensuring they are processed through the intake process in a timely manner. This position is also responsible for obtaining the patient's benefits, prior authorizations and/or predeterminations, providing support and training to junior team members, and working closely with cross-functional teams to improve processes that drive prompt and accurate reimbursement, ultimately contributing to the company's financial health.

Responsibilities

• Processes orders from referral sources
• Assesses patient needs upon arrival
• Responds to all phone and fax inquiries
• Verifies patient's benefits and eligibility for requested services
• Obtains all necessary information required to process a prior authorization if applicable
• Completes all patients start of care paperwork
• Relays insurance coverage to referral source/patient and discuss financial responsibilities and any need for financial assistance
• Enters all new patients into database
• Receives and uploads all documents received into patient's file
• Monitors referrals and assess any of their needs
• Assist clients and staff with referral questions when needed
• Assists in training new employees
• Assists intake staff to maximize the Company's value by onboarding patients quickly and accurately to optimize cash flow
• Collaborate with teammates to continually refine and improve processes and procedures
• Other duties as assigned

Skills

• Ability to work in a remote environment/home setting
• Ability to lead others
• Solid organizational skills, adaptable to changing priorities, with the ability to maintain accurate documentation and records
• Excellent communication skills with the ability to effectively relay information
• Understanding of compliance with state and federal laws and regulations

Requirements

• 3+ years of experience working within an intake department in a specialty area such as specialty pharmacy, home infusion, ambulatory infusion centers, or other comparable healthcare services
• Experience working with healthcare insurance with the ability to evaluate options and make effective decisions
• Proficiency with Microsoft Office Suite programs, electronic medical records, and use of the internet

Qualifications

• Pharmacy Technician certification
• Pharmacy Technician registration: if not registered, the individual must register as a TX Pharmacy Technician Trainee and complete licensing requirements in the time allotted by the State Board of Pharmacy
• 3+ years of experience intake processing in specialty pharmacy infusion
• Experience verifying benefits eligibility and discussion out of pocket benefits
• Experience with benefits authorizations
• Experience processing prior authorizations
• Experience with start of care paperwork
• Familiar with benefits investigations

Benefits

In addition to your salary, we offer benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).

Pay

The hourly pay for this role will range from $20 - $36 per hour based on several factors including but not limited to local labor markets, education, work experience, and certifications.