Intake Specialist
PROMPT CARE COMPANIES INC
Job Type
Full-time
Reports to: Departmental Lead, Supervisor or Manager
Job Type: Full-Time, 40 hours per week, Monday - Friday Location: Hybrid, out of either New Providence, NJ or Lenexa, KS
Requirements
- High school diploma or GED
- Previous experience working with insurance companies and healthcare professionals (physicians, nurses, etc.) is preferred
- Previous experience with specialty pharmacy patient admissions and customer service in a similar referral source-based practice setting is strongly preferred
- IVIg case management experienced preferred
- Must have strong PC skills, especially the MS Office suite. Previous experience with the pharmacy order processing system, CPR+, is a major advantage (although training will be provided)
- Obtains initial patient referral admission data and documents
- Directly interfaces with external clients and obtains initial authorization
- Notifies appropriate staff of all pending referrals and patient admissions
- Enters new patient information into the order processing system
- Generates and tracks forms (e.g., LMN, AOB, Consent for Treatment) until all pertinent documentation is received
- Consistently updates patient and clinical information in the order processing system
- Manages patients on the master log every day and forwards to appropriate staff
- Responsible for verifying eligibility and benefits through insurance companies including obtaining prior authorizations and/or pre-determinations
- Communicates in writing or via phone with clients, family members, agents, physicians and discharge planners on eligibility requirements, policy benefits, eligibility determinations and contract provisions
- Proactively researches and resolves issues impacting benefit coverage and revenue optimization
- Performs medical /pharmacy benefit verification requiring complex decision skills based on payer and process knowledge resulting in on boarding or case determined a "no go"
- Contacts benefit providers to gather policy benefits/limitations
- Coordinates and ensures services provided will be reimbursable (e.g., deductible amounts, co-payments, effective date, levels of care, authorization, etc.)
- Communicates with patients regarding Welcome and Financial call information
- Works closely with the billing department for re-authorizations or billing needs, etc.
- Other duties assigned
- Comprehensive Medical, Dental, and Vision Package
- 401(k) Plan with Company Match
- Generous PTO: Vacation, Sick Time, Personal Days, and Paid Holidays
- Life Insurance: Standard coverage with optional enhancements
- Employee Assistance Program: Free counseling and coaching sessions
- Emotional Well-being and Work-Life Balance Resources
- Short & Long-Term Disability: Company-paid with optional supplements
- Accidental Death and Dismemberment Insurance
- FSA and HSA: Manage healthcare expenses
- Commuter Spending Programs
- Volunteer and Engagement Opportunities
- Employee Referral Bonuses
- Exclusive Discounts on entertainment, travel, and various other supplemental and cellphone plans
Vacancy posted 1 day ago
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