Infusion Intake Manager

* Home Infusion experience required - IVIG products preferred*

** Remote position

Advanced Infusion Care, a division of AIS Healthcare, is the leading provider of Home Infusion Therapy. With our diverse culture, and our values around Innovation, Stewardship, and Unity, we are committed to Advancing Quality and Improving Lives. We are dedicated to doing more for our patients by providing quality products and services that enhance the entire care experience.

We are seeking a highly motivated and detail-oriented Intake Manager to lead and manage our Intake Team to include suites/centers, in addition insurance verification and authorization processes, specializing in infusion for AIC services. This role will oversee the daily operations of the insurance verification and authorization team, ensuring compliance with insurance requirements, maximizing reimbursement, and improving overall revenue cycle efficiency.

The ideal candidate will have in-depth knowledge of insurance verification, prior authorization processes, medical coding, and healthcare billing practices, with a strong background in IG and Specialty therapies. The individual will also have proven leadership experience in managing a team through process changes and be able to collaborate effectively with peers to drive operational improvements.

AIS Healthcare offers great benefits, including health, vision and dental insurance, long term disability insurance, life insurance, a vacation package, 401K plan with a generous employer match, work from home opportunity, growth, and more!

• A high school diploma or general education degree (GED) equivalent is required; bachelor’s degree preferred.
• 5-7 years of healthcare industry experience with 3-5 years Verification & Authorization Management & Leadership experience required.
• Home Infusion, IG and Specialty experience preferred. Familiar with suites and centers.
• Proven leadership experience managing and transitioning teams through process changes.

• Lead, train, and manage a large team, ensuring all team members are equipped to handle insurance verification and authorization tasks efficiently.
• Successfully guide the team through process transitions, providing support and clear communication during change management initiatives.
• Set performance goals, monitor team progress, and conduct regular performance reviews.
• Foster a collaborative, positive, and efficient work environment within the team, promoting teamwork and open communication.
• Oversee the verification of patient insurance eligibility, benefits, and coverage, specifically related to infusion and pain management treatments.
• Ensure timely and accurate submission of prior authorization requests, ensuring that all documentation and medical necessity criteria for infusion and pain management services are met.
• Maintain and update records of all authorizations and verifications to ensure accuracy and compliance with payer requirements.
• Ensure compliance with payer requirements, federal and state regulations, and internal policies, specifically focusing on infusion and pain management services.
• Stay up to date with changes in insurance guidelines, infusion therapy requirements, pain management protocols, and healthcare regulations.
• Ensure adherence to payer-specific rules regarding pre-certifications, medical necessity, and eligibility criteria for infusion and pain management services.
• Collaborate with the billing team to resolve discrepancies between verification/authorization and billing, with a focus on infusion and pain management services.
• Ensure timely and accurate completion of the verification process to avoid claim denials.
• Proactively address issues that may lead to claim denials or delays in reimbursement for infusion and pain management treatments
• Prepare and analyze reports related to insurance verification and authorization activities, with an emphasis on infusion and pain management services.
• Work with senior management to implement strategies that increase operational efficiency and improve financial outcomes, particularly for infusion and pain management services.
• Serve as the primary point of contact for internal departments and external insurance companies regarding verification and authorization issues, particularly for infusion and pain management services.
• Provide excellent customer service to patients, providers, and insurance representatives.
• Educate patients on their insurance benefits and authorization…