Home Infusion Intake Coordinator

AIS Healthcare; California; Hybrid; USD 25,000 - 36,000; Full time

Benefits offered by this job

Health insurance

Vision insurance

Dental insurance

Disability insurance

Life insurance

Vacation package

401K with employer match

Remote work from home

Growth opportunities

Job summary

Advanced Infusion Care, a division of AIS Healthcare, seeks an experienced Intake Coordinator. This full-time role provides patient access by verifying insurance eligibility, benefits, and intake authorizations. Remote work from home is available, with an office option for those who prefer it.

The ideal candidate has strong communication, attention to detail, and knowledge of benefits verification, regulatory compliance, and prior authorizations. California payer experience is preferred.

Qualifications

• High school diploma or GED required; 2+ years in customer service or medical billing.
• Experience with California payers preferred.
• Strong communication, time management, and accuracy required.
• Knowledge of insurance benefit verification and prior authorization processes.
• Ability to train associates and lead workflow improvements.

Responsibilities

• Enter demographic, physician, insurance, and authorization data into patient profiles.
• Review incoming prescriptions and attach to profiles.
• Contact patients or physicians to fill missing information.
• Conduct comprehensive benefits investigations for new referrals.
• Obtain clinical documentation for prior authorization.
• Follow up on authorizations through the process.
• Communicate status to patients, physicians, and departments.
• Explain coverage and payment responsibilities to patients.
• Identify in-network providers when insurance constraints apply.
• Train new associates and provide guidance.
• Ensure compliance with regulatory requirements.

Skills

Excellent communication

Time management

Attention to detail

Insurance verification

Customer service

Medical billing knowledge

California payers knowledge

Education

High school diploma or GED

Tools

Microsoft Office

Job description

Home Infusion experience required - IVIG products preferred*

*** Remote position (office optional)

Advanced Infusion Care, a division of AIS Healthcare, is the leading provider of Home Infusion Therapy. 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.

Advanced Infusion Care is looking for an experienced and motivated Intake Coordinator to join our dynamic team! The Intake Coordinator role is a full-time position responsible for providing patient access to the medication and therapies needed by contacting insurance companies and verifying the patient’s health insurance eligibility, benefits, coverage/non-coverage information and initiation/extension of authorizations.

The perfect candidate should have outstanding communication and time management skills, extreme attention to detail and accuracy, have in-depth knowledge of insurance benefit verification, and work in compliance with Federal and State rules and regulations.

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, remote work from home opportunity, growth, and more!

REQUIRED EDUCATION AND EXPERIENCE:

A high school diploma or general education degree (GED) equivalent is required; minimum 2 years’ experience in customer service, medical billing and coding, benefits verification, healthcare, or similar vocations. Specifically seeking experience with California payers.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Enter all required demographic, physician, insurance, authorization, and other information into a profile for all new patients.
• Review all incoming faxed prescription orders and attach to new or existing patient profile.
• Contact patient or physician to fill in any missing information.
• Conduct comprehensive benefit investigation for new patient referrals. Evaluate pharmacy benefit plans and medical benefit plans.
• Obtain clinical, lab, and medical testing documentation from physicians’ offices for submission of prior authorization.
• Perform timely follow up on authorizations through the process until approved.
• Communicate with patients, physicians, and other departments on benefits and the status of authorization requests.
• Communicate denials to physicians’ offices and provide follow up details on the peer to peer or appeal options.
• Regularly communicate the status of the intake process to other departments, including Nursing, Pharmacy and Sales.
• Notify patients/families/referral sources regarding coverage and payment responsibilities as necessary.
• Provide explanation and paperwork for Care Support Program to patients who express financial hardship. Utilize manufacturer co-pay cards as appropriate.
• Document in the patient’s clinical record progress notes, all requests and conversations for the purposes of seamless coordination of care.
• Identify in-network or mandated pharmacy providers if unable to service a patient due to insurance constraints. Communicate related information to the patient and the physician offices and triage referral as directed.
• Provide leadership, oversight, and technical guidance to associates, and assist to resolve difficult cases. Train new associates.
• Suggest and develop documentation to standardized workflow process changes and submit for approval. Assist to document authorized process changes to Job Aids.
• Participate in any variety of meetings and work groups to integrate activities, communicate issues, obtain approvals, resolve problems and maintain specified level of knowledge pertaining to new developments, requirements, and policies.
• Train new and existing associates in the use of pharmacy software system, supplemental applications, customer service techniques, job responsibilities, and departmental workflow.
• Identify deviations from training and/or processes during normal work activity.
• Serve as the SME for new applications, software upgrades, work queues, accuracy and other related processes.
• Promote training participation and coach associates in following new and existing workflow processes. Deliver messages that promote change.
• Comply with and adheres to all regulatory compliance areas, policies and procedures and company “best practices”.
• Responsible for adhering to the quality, production, and turnaround standards associated with the department and/or assigned program.
• Other duties as assigned

PREFERRED EXPEREINCE – Home Infusion Coordination

QUALIFICATION REQUIREMENTS:

• Ability to communicate effectively and professional with patients, physicians, and coworkers.
• Active listening, speaking, understanding, and writing English.
• Ability to make decisions, solve problems, and work independently with minimal supervision.
• Proven knowledge and complete utilization of processes, systems and techniques to ensure successful authorization.
• Proven ability to identify gaps and problems from review of documentation, determine lasting solutions, make effective decisions, and take necessary corrective action.
• Demonstrate excellent leadership capabilities.
• Ability to effectively teach and demonstrate proper interactions with patients and prescribers in a manner that is easy to grasp and allows for interactive learning.
• Enjoys working in a team-oriented, service-focused environment.
• Demonstrate extreme attention to detail and accuracy.
• Ability to prioritize and meet deadlines.
• Basic computer proficiency.
• Knowledge in the use of Microsoft applications.

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, combines 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.