Job Description

Job Description

Job Description

JOB SUMMARY:

The Intake Specialist I is responsible for taking all referrals received from referral sources such as physician offices, discharge planners, case managers, and other sources. Ensures that all intake forms are complete, clear and within company’s scope of service. Enters patient demographics into the computer system, verifies insurance, obtains a valid physician order, communicates ability to service the customer to the referral source, communicates with other departments to facilitate the processing of the delivery and notifies patients/families regarding coverage, payment responsibilities and delivery schedules. Daily responsibilities include the development of relationships with referral sources and communication with outside sales team.

QUALIFICATIONS:

• High School Diploma or attainment of a GED through an accredited institution. Two years of college education preferred.
• Advanced knowledge of English, both verbal and written including correct grammatical form. Familiarity with automated office equipment including computers, calculators, copiers and telephone systems.
• Working knowledge of Medicare, Medicaid, third party insurance company guidelines and regulations, medical terminology, and medical billing codes.
• Should be well-versed in regulatory guidelines and industry standards for Medicare and/or specific payer benefit providers; Insurance and Third Party payer systems and guidelines to facilitate the verification of insurance coverage for services provided by the company.
• 0 to 2 years of experience with a Home Infusion Company, Home Health Agency or in another health-care provider environment performing intake referral coordination, insurance verification, or confirmation of Third-Party billing.
• Ability to thrive in a diverse function in an ever evolving department; must have ability to multi-task in a somewhat fast-paced environment without sacrificing quality or production goals
• Familiar with accepted medical terminology, diagnosis codes, insurance verification, billing, and collection practices in a health care setting
• Possesses good interpersonal skills; ability to work independently and as part of a team.
• Facilitates work production results by incorporating exceptional planning and organizational skills
• Utilizes clear verbal communication skills to source and exchange information; utilizes written communication skills to prepare documentation and report results as warranted by job responsibilities
• Ability to identify problems within the work routine that can be handled at level and refer escalated matters for further resolution and follow-up to Supervisor or Manager
• Computer literacy in standard office applications; i.e. Windows, MS Word, Excel; ability to learn and master industry specific software applications such as CPR+
• Promotes a philosophy that is customer driven with excellent service results.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Completes all referrals with thorough and accurate information that is entered in a timely manner into the company software system.
• Enters data into computer system in a timely manner and insures that data is accurate and complete.
• Obtains the appropriate physician orders and/or SMN necessary to provide the therapy.
• Adherence to legal and ethical guidelines for safeguarding and maintaining the confidentiality of patient and proprietary information.
• Adheres to HIPAA regulations by maintaining the confidentiality of patient health information (PHI)
• Communicates in a professional and positive manner with all clients and referral sources.
• Coordinates verification of insurance and notifies patient of any deductible/co-pay due.
• Obtains credit card confirmation for patients designated as pre-pay prior to shipment.
• Processes referrals and new orders based upon current contracts and information from payor sources including obtaining appropriate authorizations/re-authorizations for services where required.
• Ensures that the appropriate departments receive the referral in a timely fashion.
• Uses time management skills to manage daily workload so that the needs of patients are met.
• If unable to accept a referral, notifies referral source and all departments. Assists with alternative solutions as needed.
• Consistent timely communication and follow-up with the clinic, patient, NTC and pharmacy to coordinate needed infusion services for patients that have been referred to the company.
• Performs job responsibilities within established regulatory guidelines (HIPAA / PHI) and reports non-compliant activity to Manager; protects patient and company confidentiality in all matters of processing accounts. Attends in-service or classes to remain current on regulations and procedures.
• Provides exceptional service to patients, internal and external customers and third party payors; interacts in a professional manner with all contacts in order to promote effective exchanges of information
• Integrates new technologies, tools or system applications that have the ability to increase production via streamlines processes or procedures into day-to-day processing of referrals.
• Other duties as assigned.

BENEFITS:

Our company offers competitive pay, incentive programs, generous paid time off, paid holidays, health insurance, life insurance, wellness, retirement, educational assistance, career growth, and much, much more!!

You must be able to pass a drug, background screen and be eligible to work in the U.S.

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