Home Infusion Intake Coordinator

Advanced Infusion Care, a division of AIS Healthcare, is looking for an experienced and motivated Intake Coordinator to join our dynamic team. The Intake Coordinator role is a full-time position responsible for providing patient access to the medication and therapies needed by contacting insurance companies and verifying the patient's health insurance eligibility, benefits, coverage/non-coverage information and initiation/extension of authorizations.

The perfect candidate should have outstanding communication and time management skills, extreme attention to detail and accuracy, have in-depth knowledge of insurance benefit verification, and work in compliance with Federal and State rules and regulations.

Essential Duties and Responsibilities

• Enter all required demographic, physician, insurance, authorization, and other information into a profile for all new patients.
• Review all incoming faxed prescription orders and attach to new or existing patient profile.
• Contact patient or physician to fill in any missing information.
• Conduct comprehensive benefit investigation for new patient referrals. Evaluate pharmacy benefit plans and medical benefit plans.
• Obtain clinical, lab, and medical testing documentation from physicians' offices for submission of prior authorization. Perform timely follow up on authorizations through the process until approved. Communicate with patients, physicians, and other departments on benefits and the status of authorization requests. Communicate denials to physicians' offices and provide follow up details on the peer to peer or appeal options.
• Regularly communicate the status of the intake process to other departments, including Nursing, Pharmacy and Sales.
• Notify patients/families/referral sources regarding coverage and payment responsibilities as necessary.
• Provide explanation and paperwork for Care Support Program to patients who express financial hardship. Utilize manufacturer co-pay cards as appropriate.
• Document in the patient's clinical record progress notes, all requests and conversations for the purposes of seamless coordination of care.
• Identify in-network or mandated pharmacy providers if unable to service a patient due to insurance constraints. Communicate related information to the patient and the physician offices and triage referral as directed.
• Provide leadership, oversight, and technical guidance to associates, and assist to resolve difficult cases. Train new associates.
• Suggest and develop documentation to standardized workflow process changes and submit for approval. Assist to document authorized process changes to Job Aids.
• Participate in any variety of meetings and work groups to integrate activities, communicate issues, obtain approvals, resolve problems and maintain specified level of knowledge pertaining to new developments, requirements, and policies.
• Train new and existing associates in the use of pharmacy software system, supplemental applications, customer service techniques, job responsibilities, and departmental workflow.
• Identify deviations from training and/or processes during normal work activity.
• Serve as the SME for new applications, software upgrades, work queues, accuracy and other related processes.
• Promote training participation and coach associates in following new and existing workflow processes. Deliver messages that promote change.
• Comply with and adheres to all regulatory compliance areas, policies and procedures and company best practices.
• Responsible for adhering to the quality, production, and turnaround standards associated with the department and/or assigned program.
• Other duties as assigned.

Preferred Experience - Home Infusion Coordination.