Intake Coordinator - Bleeding Disorders

The Intake Authorization Coordinator will facilitate all phases of intake to include benefits verification, authorization, and patient financial counseling while coordinating needed interaction with Caregivers, Physicians, and other internal/external stakeholders during the execution of these functions. This person will work under the direct supervision of the intake manager and program manager; Intake-Authorization collaborating with the healthcare team to provide exceptional value to our customers. This individual will be a key contributor and should be an experienced professional in this segment of care delivery. The successful candidate will perform all duties in accordance with company policy/procedure, state professional standards, and other applicable regulatory requirements.

Principal Roles and Responsibilities:

Must be experienced with insurance coverage for infusion products, specific health plans, and have familiarity with key requirements necessary for accurate benefit checks and authorizations.

Able to accurately identify guidelines, coverage rules, and obtain prior authorization as well as certificates of medical necessity when needed.

Have experience with Pharmacy management software for infusion

Ability to maintain accurate and complete records.

Communicates and resolves problems with patient/customer, physicians’ offices, referral sources, third party insurance companies, Medicaid and Medicare.

Proven track record and ability to work with reporting to follow up on prior authorizations.

Ability to assess what is needed and work effectively with all members of the Hemophilia and related Bleeding Disorders Team including Pharmacists, Nurses, Pharmacy Technicians, and Sales to accomplish goal.

Team player willing to assist with office duties like filing, putting together charts and other duties as assigned.

Complete administrative task associated with onboarding patients in pharmacy management system

Utilize pharmacy management system to perform benefit investigation and prior authorization support

Complete related documentation to all related tasks in pharmacy management program

Assists with answering and directing phone calls.

Ability to work effectively with revenue team to maximize billing and collection of insurance claim receivables.

Desire to educate themselves on the scope of services that are available through company and understand basic drug terminology and therapies/services provided.

Actively support company mission, organizational/departmental policies, and procedures

Presents a professional appearance & approach with members & other employees; demonstrates honest & ethical behavior. Handles member & employee info w/appropriate sensitivity & safeguards to ensure confidentiality & right to privacy, in compliance w/HIPAA regulatory requirements

Contributes to the effectiveness of the team by working together by supporting, promoting & applying the best practice standards of conduct including those on attendance, mutual respect & support, honoring diversity, effective communication, & improving the work environment

Exhibits flexibility when work assignments need to be adjusted to meet service, delivery and workload needs of team

Takes initiative to identify, develop & adapt new policies and practices to improve quality of work

Performs other related duties as assigned by management

Maintain confidentiality of patient and proprietary information at all times

Observe legal and ethical guidelines for safeguarding the confidentiality of patient and proprietary company information

Understand and comply with HIPAA

For all activities complies with accreditation, legal, regulatory, government and safety requirements