Infusion Intake Coordinator I

About This Role

The Infusion Intake Coordinator I plays a crucial role in the healthcare system by ensuring that patients receive timely and accurate infusion therapy services. This position involves coordinating patient intake processes, verifying insurance information, and facilitating communication between patients, healthcare providers, and insurance companies to streamline patient care and improve overall patient satisfaction.

Responsibilities

• Requesting, receiving and inputting incoming prior authorizations, patient information, and eligibility data accurately and timely into the Electronic Medical Records (EMR) system
• Viewing requests and clinical packets to ensure all necessary information is included and accurate
• Scrubbing schedules to ensure patients have complete and necessary insurance and claims information to complete the process
• Verifying all diagnosis codes for accuracy and to ensure they meet reimbursement/payables eligibility
• Performing insurance benefit verification and prior authorization for each patient and securing pre-determinations if prior authorizations have not been obtained
• Maintaining prior authorization and pre-determination communications regarding status/receiving request and submitting appeal and peer-to-peer letters
• Maintaining the online share file so all information is entered and current and accurate
• Enrolling patients with Pharmaceutical Copay Assist Programs per eligibility requirements
• Communicating financial policies to patients accurately
• Monitoring the daily infusion schedule and scheduling patients accordingly
• Entering patient insurance verification/authorization forms and demographic information into the EMR system accurately and timely
• Assisting Lead in investigating denial claims as needed
• Maintaining a high level of constant attention to detail, critical thinking and problem solving, to resolve issues as they arise

Requirements

• Associate's degree with 2 years or any combination of education and work experience in a customer service-related role
• Prior experience obtaining insurance prior authorizations, pre-determinations, pre-certifications and an understanding of insurance coverages and participation
• Previous experience in a healthcare setting, preferably in patient intake or coordination
• Previous experience working in a medical/clinical setting
• HIPAA compliance regarding PHI
• Working knowledge of computers, internet access, and the ability to navigate within Microsoft Office Suite, or similar programs
• Demonstrated excellent verbal and written communication skills
• Excellent phone and written skills

Qualifications

• Associate's degree or equivalent combination of education and work experience
• 2 years of work experience in a customer service-related role, prior experience obtaining insurance prior authorizations/pre-determinations, and previous experience in a healthcare setting

Nice to Have

• Bachelor’s Degree
• Bilingual (English/Spanish)
• Prior experience in Rheumatology
• Experience with NextGen and Availity software
• High degree of ownership, attention to detail, and trustworthiness
• Able to work in a high volume/fast-paced environment
• Ability to work successfully within a team-oriented atmosphere

Skills

* Required skills