Specialty Services Intake Coordinator/ IV Benefit Verification

Job Description

Job Description

Position Summary

Busy Infectious Disease and Infusion Clinic is seeking an experienced  Insurance Verification & Authorization Specialist to join our team. The ideal candidate will have experience with  insurance verification, prior authorizations, medical billing, IV antibiotics, and infusion services .

This position requires excellent organizational skills, attention to detail, strong communication skills, and the ability to effectively  multitask and prioritize in a fast-paced clinical environment . The successful candidate will work closely with patients, insurance companies, referral sources, providers, case managers, pharmacy staff, and other members of the healthcare team to ensure services are appropriately verified and authorized.

A High School Diploma or equivalent is required. Healthcare insurance verification, authorization, and billing experience is strongly preferred.

Essential Duties & Responsibilities

• Receive referrals from outside providers, internal case managers, hospitals, and other referral sources.
• Review and assess referrals for potential clinic services, infusion services, specialty medications, and home IV therapy.
• Provide professional and responsive customer service to patients, referral sources, providers, and insurance representatives.
• Verify patient insurance eligibility and benefits for  clinic, infusion, specialty pharmacy, and home IV services .
• Obtain required referrals, prior authorizations, and other insurance approvals in a timely manner.
• Manage referrals from initial intake through authorization, scheduling, and re-authorization as required.
• Maintain accurate documentation and ensure authorizations remain current throughout the patient's course of treatment.
• Coordinate with pharmacy staff and outsourced pharmacy vendors to ensure medications are authorized, ordered, and received prior to the patient's scheduled appointment.
• Enter new patient demographics and insurance information into the EMR system using hospital face sheets and referral documentation.
• Accurately and timely document all verification, authorization, referral, and patient information in  Intergy .
• Communicate with insurance companies regarding benefits, coverage requirements, authorizations, denials, and additional documentation.
• Review and respond to patient, insurance, and referral-source questions and correspondence to facilitate completion of verification and authorization requirements.
• Counsel patients regarding insurance coverage, estimated financial responsibility, deductibles, copays, coinsurance, and other applicable financial obligations.
• Identify authorization or eligibility issues that may delay patient care and communicate concerns promptly to the appropriate team members.
• Maintain confidentiality and comply with HIPAA and all applicable healthcare regulations.
• Perform other duties as assigned.

Qualifications

• High School Diploma or equivalent required.
• Previous experience in  insurance verification, prior authorization, medical billing, or healthcare reimbursement required.
• Experience with  IV antibiotics, infusion therapy, specialty medications, or home IV services strongly preferred.
• Knowledge of commercial insurance, Medicare, Medicaid, and other payer requirements preferred.
• Experience working with EMR systems;  Intergy experience is a plus .
• Strong attention to detail and accuracy.
• Excellent written and verbal communication skills.
• Ability to multitask, prioritize competing responsibilities, and meet deadlines.
• Strong problem-solving and organizational skills.
• Ability to work independently while functioning effectively as part of a multidisciplinary team.
• Professional, compassionate, and patient-focused approach.

Benefits

We offer a  competitive salary and excellent benefits package for eligible full-time employees.