JOB TITLE: Patient Access Specialist - Intake (Remote)
COMPENSATION: $19.25 - $20.25 / hour
BENEFITS: Medical, Dental, Life, Vision, 401K with Match, Bonus Eligible
EMPLOYMENT TYPE: Full Time
REPORTS TO: Revenue Operations Manager
FLSA Status: Non - Exempt
GENERAL PURPOSE OF THE JOB:
The individual in this position will support the Infusion Intake Process. This person will collaborate and support the Revenue Operations Lead and Manager by ensuring the thorough and accurate processing of referrals, authorizations, and insurance eligibility verifications. The individual is responsible for prioritizing, organizing, and completing assigned responsibilities and tasks in a timely manner.
PRIMARY DUTIES AND RESPONSIBILITIES:
Patient Intake Specialist:
- Verify insurance eligibility and benefits.
- Review and identify referral packet elements to ensure all required information is received from referring offices.
- Ensure referral packet and all relevant information is received and scanned to the appropriate location in the medical record & billing system.
- Maintain working knowledge of all insurance contracts.
- Maintain working knowledge of applicable CPT, HCPC, and ICD-10 codes.
- Contact insurance company with all appropriate codes to obtain correct prior approval(s) for referrals and maintain ongoing approvals for continued payment.
- Research and review insurance medical policies to ensure the referral meets all requirements and guidelines to include step therapy requirements, diagnosis conditions, dosing limitations, etc.
- Become familiar with drug copay assistance program requirements to identify whether a patient meets base eligibility conditions.
- Report referral progress in tracking system.
- Data entry of patient information into electronic medical record.
Communication:
- Execute good written and verbal communication skills when interacting with corporate insurances, internal and clinical staff, referring provider offices, and patients.
- Communicate and maintain contact with Patient Care Navigator and Patient Resource Operations Teams regarding patient accounts to discuss concerns such as missing referral documents, COB issues, patient financial concern, authorizations, and referrals.
- Utilize appropriate templates, conventions, formats, and distributions for communication via email and all applicable tracking, notation, and communication systems.
SECONDARY DUTIES AND RESPONSIBILITIES:
- Assist in various projects such as account audit reports, system update projects, data entry & reconciliation, acquisition assistance, etc.
- Input information on appropriate tracking spreadsheets.
- Maintain patient records and confidentiality via the electronic Medical Record System.
- Develops an effective communication mechanism for the Home Office to promote a positive image with clinics, patients, visitors, co-workers, physicians, office personnel, and external agencies.
- Attends necessary meetings related to department activities.
- Performs other duties as assigned.
QUALIFICATIONS:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Minimum 1-2 years of related prior work experience required, preferably in the healthcare industry.
- Proven competencies can take precedence over prior work experience.
- High school graduate or equivalent; associates or bachelor’s degree preferred.
- Proficient (intermediate level of application) with all Microsoft Office Products programs.
- Knowledge of Medicare & commercial/private insurance benefits, medical authorizations and billing, HIPAA, and medical abbreviations and terminology preferred.
- Must possess outstanding communication and interpersonal skills, be able to communicate professionally and effectively with other staff members, patients, vendors, and physicians, and is fluent in written and spoken English.
- Experience supporting multiple managers/supervisors.
- Travel minimal in this role but can be up to 10%.
- Prior experience working with sensitive information and maintaining confidentiality.
WORK ENVIRONMENT & PHYSICAL DEMANDS:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. The physical demands described below are representative of those that must be met by an employee to successfully perform the essential functions of this job.
The employee is frequently required to sit and infrequently required to stand, lift and/or move up to 25 pounds. While performing the duties of this job, the employee is required to sit, stand; walk and talk, and hear. Requires excellent visual dexterity and manual dexterity.