InfuCare Rx is a leading home infusion provider accredited by URAC and ACHC offering a specialized approach to caring for patients in need of IV therapy and specialty pharmacy services in the homecare setting. We have created an ethical, team oriented, and quality work environment for our employees that cultivates achievement and success.
Job Description
The Intake Authorization 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 work under the direct supervision of the intake manager and program manager; Intake-Authorization collaborating with the healthcare team to provide exceptional value to our customers. This individual will be a key contributor and should be an experienced professional in this segment of care delivery. The successful candidate will perform all duties in accordance with company policy/procedure, state professional standards, and other applicable regulatory requirements.
Principal Roles and Responsibilities
- Must be experienced with insurance coverage for infusion products, 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 patient/customer, 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 Hemophilia and related Bleeding Disorders Team including Pharmacists, Nurses, Pharmacy Technicians, and Sales to accomplish goal.
- Team player willing to assist with office duties like filing, putting together charts and other duties as assigned.
- Complete administrative task associated with onboarding patients in pharmacy management system
- Utilize pharmacy management system to perform benefit investigation and prior authorization support
- Complete related documentation to all related tasks in pharmacy management program
- 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 & approach with members & other employees; demonstrates honest & ethical behavior. Handles member & employee info w/appropriate sensitivity & safeguards to ensure confidentiality & right to privacy, in compliance w/HIPAA regulatory requirements
- Contributes to the effectiveness of the team by working together by supporting, promoting & applying the best practice standards of conduct including those on attendance, mutual respect & support, honoring diversity, effective communication, & 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 & 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 HIPAA
- For all activities complies with accreditation, legal, regulatory, government and safety requirements
Minimum Education, Certification and Experience/Skill Requirements
- High School diploma or equivalent. College degree is preferred.
- Minimum of (2) years’ experience as an Intake Authorization Coordinator
- Excellent Communication skills including reading, writing, and speaking to effectively handle position responsibilities
- Experience providing customer service to internal and external customers, including meeting quality standards for services, and evaluation of customer satisfaction
- Computer skills and knowledge of how to enter and access data. Knowledge of Excel, Internet, and Word Processing.
- Understand how to calculate and check for correct doses of medication.
- Ability to calculate figures and amounts such as discounts, interest, and percentages.
- Must demonstrate strong attention to detail.
- Possess ability to prioritize, perform multiple tasks at one time, and have good organizational skills.
- Work under stress effectively.
Highly Preferred Certification and Experience/Skill Requirements
- Experience with intake related to hemophilia and associated bleed disorders
- Experience working in an acute or specialty infusion pharmacy
- Experience with CPR+ Pharmacy Management System
Physical Demands
Required to stand, walk, sit, talk and hear; required to use hands to operate vehicles and office equipment; must be able to occasionally lift and/or move up to 25 lbs; specific vision requirements for this job include: close, distance and peripheral vision, and the ability to adjust focus, reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position without compromising patient care.
InfuCare Rx is an equal opportunity employer. All employment decisions are made without regard to race, color, religion, national origin, military status, marital status, citizenship/immigration status, sex (including pregnancy and relation conditions, sexual orientation, or gender identity), age (40 and older), disability, genetic information (including employer requests for, or purchase use, or disclosure of genetic tests, genetic services, or family medical history), retaliation for filing a charge, reasonably opposing discrimination, or participating in a discrimination lawsuit, investigation, or proceeding. Background checks and drug screens are part of our hiring process. Affirmative Action/Equal Opportunity Employer, Minority/Female/Disabled/Veteran.
lick here to view our drug testing policy
https://infucarerx.com/wp-content/uploads/2024/08/Drug-Testing-Policy-for-Texas-Applicants_08072024.pdf [https://infucarerx.com/wp-content/uploads/2024/08/Drug-Testing-Policy-for-Texas-Applicants_08072024.pdf]
