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Recurring Intake Specialist

AG Urgent Care
Remote, USA
Full-time
Mid
Remote
Discovered 1 months ago
CortexPrismDME

Full Job Posting

Responsibilities

  • 1. Ensure that patient’s file is always up to date in terms of records and documents.
  • 2. Recurring List – must be fully in charge of the list.
  • Enter New Patient Updates
  • Comments
  • Prior Auths with Date Spans
  • Status etc.
  • 3. Check Eligibility every month – before delivery and ALWAYS on 1st of the month for each patient being delivered that day
  • Save a dated copy of insurance eligibility in patient file (eligibility folder)
  • Review RX, MR, LMN – make sure all is updated every 6 months
  • 4. Check Auth status – those that are on their final month are PRIORITY to get new auth
  • 5. Request Prior Auth when expired
  • 6. Check Delivery Schedule daily and cross reference recurring patients
  • 7. Create Order in Cortex – once eligibility and prior auth are confirmed
  • 8. Once all approved, put Delivery Ticket into folder called ‘To Be Delivered’
  • 9. Confirm with Scheduler that delivery is complete – notate in Recurring List
  • 10. If patient changes insurance – add to QUE when necessary
  • 11. Listen to voice mails and respond to all calls 12. Forward calls appropriately if call is related to a different case.
  • 13. Scan and put all documents appropriately to the patient file.
  • 14. Report all problems encountered.
  • 15. Point out solutions to the problem to help improve certain aspects of the process.
  • 16. Process orders from referral sources and patients, responding to phone and fax inquiries, and resolving patient complaints.
  • 17. Provide information pertaining to equipment, supplies and services.
  • 18. Manage and respond all incoming referrals and maintain track of all inquiries.
  • 19. Review the weekly eligibility report and ensure that all corrections are made to patient demographic information.
  • 20. Provide follow-up calls if required and participate in all quality assessment activities and assist to collect and analyze all information and recommend required improvements to all processes.
  • 21. Monitoring active authorization, if authorization is about to expire, it will request Rx refill and MR for continuous authorization. Requesting Rx refill and MR for patients without authorization for billing and other purposes.
  • 22. Calling patients particularly for those who recently changed their insurances
  • 23. Checking recurring orders/authorization in Prism Checking Eligibility and Benefits to Insurances 24. Creating refill orders in DME if necessary. (e.g. when authorization is approved and if documentation was received).
  • 25. Working hand on hand with Delivery and Billing Supervisors in terms of delivery questions and if tasks were given accordingly.

Qualifications

  • Strong health care management background. Expertise in operations preferred. Knowledge of healthcare fraud and compliance. Computer Literate. Must have excellent verbal communication skills and active listening skills. Must have Customer Service Skills and excellent time management.
  • Job Types: Full Time
  • If you’re interested or know someone looking for opportunity. Feel free to send your resume at [email protected] .

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