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The 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 therapy
- Facilitates 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 procedures
- Identifies participating payers and contractual pricing agreements
- Verifies health insurance coverage using verification forms
- Inquires about case management, with authorization number and pre-certification
- Obtains/maintains authorization numbers
- Performs case management updates for changes in therapy and patient status
- Once verification is complete and admission criteria is reviewed/approved by clinical staff, contacts referral source to notify of acceptance or denial of referral
- When needed, coordinates the discharge plan with the referral source/discharge planner, nursing agency when applicable, pharmacy, and patient/caregiver
- Establishes relationships with licensed and certified nursing agencies to provide clinical nursing services to pharmacy patients
- Notifies patient or approved patient advocate and explains their financial responsibilities
- Completes all applicable sections of Intake and Confirmation forms, and enters into CPR+
- Negotiates pricing with case management under the direct supervision of Center Manager
- Assists with the creation and maintenance of Medicare CMNs
- Obtains and tracks authorizations
- Completes monthly re-verification of Medicaid recipients
- Documents credit and cash co-payments made at location level
- Obtains clinical documentation necessary for billing
- Responsible for the intake of personal referrals
- Data-entry and updating patients' demographic information
- Insurance benefit verification and coordination with nursing and pharmacy staff
- Prepares and manages paperwork and documentation for billing and collections
- Resolves patient/payee issues in a timely manner
#CC
Qualifications
EDUCATION/EXPERIENCE
- high school diploma or equivalent
- 2-5 years of medical terminology, insurance verification, and/or medical services experience required
- 1-2 years of experience with home infusion preferred
- Experience with ICD-9 coding preferred
- College degree is desirable
- 2-3 years experience with home care, discharge planning, or insurance billing a plus
- Maintain a current insurable driver's license
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