Intake Coordinator

Intake CoordinatorThe Intake Coordinator acts as a liaison between the referral source and the Pharmacy to ensure a seamless transition from the acute care setting to home care for our patients.Establishes and maintains relationships with referral sources by receiving and processing intake information for potential patients who require home infusion therapyFacilitates intake process by procuring all patient information necessary to determine home infusion admission based on supportive clinical data, prescribed therapy, assignment of home infusion benefits, and following all patient acceptance criteria policies and proceduresIdentifies participating payers and contractual pricing agreementsVerifies health insurance coverage using verification formsInquires about case management, with authorization number and pre-certificationObtains/maintains authorization numbersPerforms case management updates for changes in therapy and patient statusOnce verification is complete and admission criteria is reviewed/approved by clinical staff, contacts referral source to notify of acceptance or denial of referralWhen needed, coordinates the discharge plan with the referral source/discharge planner, nursing agency when applicable, pharmacy, and patient/caregiverEstablishes relationships with licensed and certified nursing agencies to provide clinical nursing services to pharmacy patientsNotifies patient or approved patient advocate and explains their financial responsibilitiesCompletes all applicable sections of Intake and Confirmation forms, and enters into CPR+Negotiates pricing with case management under the direct supervision of Center ManagerAssists with the creation and maintenance of Medicare CMNsObtains and tracks authorizationsCompletes monthly re-verification of Medicaid recipientsDocuments credit and cash co-payments made at location levelObtains clinical documentation necessary for billingResponsible for the intake of personal referralsData-entry and updating patients' demographic informationInsurance benefit verification and coordination with nursing and pharmacy staffPrepares and manages paperwork and documentation for billing and collectionsResolves patient/payee issues in a timely mannerEducation/ExperienceHigh school diploma or equivalent2-5 years of medical terminology, insurance verification, and/or medical services experience required1-2 years of experience with home infusion preferredExperience with ICD-9 coding preferredCollege degree is desirable2-3 years experience with home care, discharge planning, or insurance billing a plusMaintain a current insurable driver's license