Experienced Intake / Verification Specialist

AIS HealthCare; Dallas (TX); Remote; USD 50,000 - 70,000; Full time

Job summary

AIS HealthCare seeks an experienced Intake / Verification Specialist with exceptional communication skills and healthcare experience. This role involves verifying patient benefits and authorizations in compliance with regulations. With a 100% remote work option, competitive benefits, and a supportive culture, this position is designed for a motivated individual who is dedicated to providing quality service.

Benefits

Health, vision and dental insurance

401K plan with employer match

Long term disability insurance

Life insurance

Vacation package

Qualifications

• 3-5 years of healthcare industry experience preferred.
• Home Infusion, Intrathecal Pain Management experience preferred.

Responsibilities

• Knowledge of patient insurance eligibility and benefits.
• Entry of insurance and authorization information into EHR systems.
• Follow-up on pending or expired authorizations.

Skills

Communication

Judgment

Attention to Detail

Interpersonal Skills

Education

High school diploma or GED

Tools

Microsoft Office

Job description

Experienced Intake / Verification Specialist

AIS Healthcare is the leading provider of Targeted Drug Delivery (TDD), and Infusion Care solutions. With our diverse culture, and our values around Innovation, Stewardship, and Unity, we are committed to Advancing Quality, and Improving Lives. We are dedicated to doing more for our patients by providing quality products and services that enhance the entire care experience.

AIS Healthcare is looking for an experienced and motivated benefit verification and authorization expert to join our dynamic team! The perfect candidate should have outstanding communication skills, an in-depth knowledge of collection practices, work in compliance with Federal and State rules, regulations, and policy related to benefit verification and authorization activities.

AIS Healthcare offers great benefits, including health, vision and dental insurance, long term disability insurance, life insurance, a vacation package, 401K plan with a generous employer match, 100% work from home opportunity, growth, and more!

Education and Experience :

• A high school diploma or general education degree (GED) equivalent is required.
• 3-5 years of healthcare industry experience strongly preferred.
• Home Infusion, Intrathecal Pain Management experience preferred.

Essential Duties and Responsibilities :

• Thorough knowledge of the processes for patient insurance eligibility and benefits for a variety of payers.
• Specific knowledge of Authorization processes relative to GAPs, Pre-determinations, PCP Referrals, and Single Case Agreements.
• Detailed and accurate entry of insurance and authorization information into EHR systems.
• Completes follow-up on pending or expired authorizations, referrals as assigned.
• Review authorization denials for accuracy; initiate the appeal process until the case is overturned, the appeal options are exhausted, or the decision is made to discontinue the process.
• Documents details of all calls per the Standard Operation Procedures of the department.
• Timely follow-up and response to all Quality Reviews.
• Recognizes patients' rights and responsibilities and supports them in the performance of job duties, respects patient's rights to privacy and confidentiality.
• Maintains strictest confidentiality; adheres to all HIPAA guidelines / regulations.
• Maintains understanding of NDC (National Drug Code) numbers, metric quantities, and knowledge of infusion supplies.
• Maintains a broad range of knowledge of insurance plans, medical terminology, billing procedures, government regulations, and medical codes.
• Shares knowledge gained with other staff members and works as a team member.
• Interacts with others in a positive, respectful, and considerate manner.
• Performs other job-related duties as assigned.

Qualification Requirements :

• Ability to recognize, evaluate and exercise good judgment in solving complex situations and advising in accordance with laws and regulations.
• Excellent verbal and written communication and relationship building skills with an ability to prioritize, negotiate, and work with a variety of internal and external stakeholders.
• Strong work ethic with personal qualities of integrity and credibility.
• Self-directed, detail oriented, conscientious, organized, and able to follow through.
• Ability to deal in an organized manner with problems involving multiple variables within the scope of the position.
• Proficient in Microsoft Office, including Outlook, Word, and Excel.

Steps to Apply :

Complete the required Culture Index Candidate Assessment (Directions to follow below in this job posting, so please read in its entirety). No application will be considered if the applicant does not follow instructions and complete the assessment as part of the application process.

Culture Index Candidate Assessment

Why does AIS utilize the Culture Index Assessment?

• We recognize how important our employees are to the success of our company. Our company continues to thrive due to a culture of teamwork and our ability to match potential hires with positions that best utilize their natural traits and skillsets. AIS utilizes the Culture Index Candidate Assessment surveys to help us select the best match for our positions.

How can I complete the assessment?

AIS HealthCare is the leading provider of advanced sterile, patient-specific intrathecal pump medications and in-home intravenous infusion, including immune globulin therapies. These services, combined with your advanced nursing and care coordination solutions, assist physicians and hospitals in delivering a superior level of care for optimal therapeutic outcomes.

We offer a wonderful work culture, looking for an impact player who is positive, earnest, and hardworking.