Intake Coordinator-Acute

Job Summary

The Intake Coordinator will facilitate all phases of intake to include benefits verification, authorization, and patient financial counseling while coordinating needed interaction with Caregivers, Physicians, and other internal/external stakeholders during the execution of these functions. This person will collaborate with the healthcare team to provide exceptional value to our customers.

Primary Responsibilities

• Must be experienced with insurance coverage for infusion, specific health plans, and have familiarity with key requirements necessary for accurate benefit checks and authorizations.
• Able to accurately identify guidelines, coverage rules, and obtain prior authorization as well as certificates of medical necessity when needed.
• Have experience with Pharmacy management software for infusion.
• Ability to maintain accurate and complete records.
• Communicates and resolves problems with patients/customers, physicians’ offices, referral sources, third party insurance companies, Medicaid, and Medicare.
• Proven track record and ability to work with reporting to follow up on prior authorizations.
• Ability to assess what is needed and work effectively with all members of the Infusion Team including Pharmacists, Nurses, IV Pharmacy Technician, and Drivers to accomplish goal.
• Team player willing to assist with office duties like filing, putting together charts and other duties as assigned.
• Assists with answering and directing phone calls.
• Ability to work effectively with revenue team to maximize billing and collection of insurance claim receivables.
• Desire to educate themselves on the scope of services that are available through company and understand basic drug terminology and therapies/services provided.
• Actively support company mission, organizational/departmental policies, and procedures.
• Presents a professional appearance and approach with members & other employees; demonstrates honest and ethical behavior.
• Handles member and employee info with appropriate sensitivity and safeguards to ensure confidentiality and right to privacy, in compliance with HIPAA regulatory requirements.
• Contributes to the effectiveness of the team by working together by supporting, promoting and applying the best practice standards of conduct including those on attendance, mutual respect and support, honoring diversity, effective communication, and improving the work environment.
• Exhibits flexibility when work assignments need to be adjusted to meet service, delivery and workload needs of team.
• Takes initiative to identify, develop and adapt new policies and practices to improve quality of work.
• Performs other related duties as assigned by management.

Confidentiality and Compliance

• Maintain confidentiality of patient and proprietary information at all times
• Observe legal and ethical guidelines for safeguarding the confidentiality of patient and proprietary company information
• Understand and comply with HIPPA
• For all activities complies with accreditation, legal, regulatory, government and safety requirements

Required Qualifications

• High School diploma or equivalent. A college degree is preferred.
• Minimum of (2) years of experience as an Intake Authorization Coordinator.
• Excellent Communication skills including reading, writing, and speaking to effectively handle position responsibilities.
• Proficiency with Microsoft Office suite products.

Highly Preferred Qualifications

• Experience working in an acute or specialty infusion pharmacy.
• Experience with CPR+ Pharmacy Management System.