Infusion Intake Specialist II

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GI Alliance is seeking an experienced Infusion Intake Specialist II.

Position purpose: Review and process infusion services and physician orders in a timely and accurate manner to obtain payment for infusion services.

Responsibilities/Duties/Functions/Tasks:

• Review physician order for Infusion.
• Verify patient benefits independently and with appropriate manufacturer hub programs.
• Determine whether practice can buy & bill or if medication needs to be obtained through a Specialty Pharmacy.
• Assist patient with foundation copay programs, if eligible for reimbursement program.
• Obtain foundation copay card information once assistance approved.
• Obtain prior-authorization for infusion services from patients insurance company by calling insurance carrier and/or submitting required forms and medical records via fax or online portal.
• If Specialty Pharmacy utilized, submit proper paperwork and patient clinical information.
• Assist in claims payment follow-up involving denials related to authorization or insurance coverage.
• Communicate necessary patient financial information with appropriate office and billing personnel in an efficient, timely and accurate manner.
• Communicate with patient regarding deductibles, copays, co-insurance, and financial assistance coverage.
• Alert supervisor of any roadblocks to timely verification, prior authorizations and payment of infusion claims.
• Provide quality service to patients.
• Abide by all federal, state, and payer requirements and regulations.
• Perform other duties as assigned.

Qualifications:

• High School Diploma or GED required; associates degree preferred.
• 3-5 years of prior infusion intake experience preferred.
• Intermediate experience (4+ years) and/or acting more independently.
• Strong and consistent performer.

Performance Requirements:

• Excellent communication skills, both written and verbal.
• Excellent customer service skills.
• Proficient in MS Office, especially Word and Excel.
• Ability to multi-task in a fast-paced environment.
• Detail-oriented.
• Strong understanding of healthcare plans and medical benefits.
• Ability to read and understand payer policies and medical terminology (CPT, ICD 10).
• Bilingual is a plus.
• Self-motivated with initiative.
• Strong ethics.

GI Alliance is an Equal Opportunity Employer. All job offers are contingent on a successful pre-employment criminal history check. Applications must be completed in full. No phone calls or agencies, please.