Infusion Intake Specialist II - Benefits & Authorization Pro

GI Alliance; Southlake (TX); On-site; USD 52,000 - 68,000; Full time

Job summary

GI Alliance is seeking an experienced Infusion Intake Specialist II to review infusion orders and verify patient benefits to secure payment for services.

You will determine buy & bill vs Specialty Pharmacy pathways, assist with foundation copay programs, and secure prior authorizations while coordinating with insurance and pharmacy partners. Experience in infusion intake is preferred.

Qualifications

• High School diploma or GED required; associate degree preferred.
• 3-5 years infusion intake experience is preferred.
• Prior infusion intake experience related to infusion needed.

Responsibilities

• Review physician orders for Infusion.
• Verify patient benefits independently and with manufacturer hub programs.
• Determine whether the practice can buy & bill or if medication needs to be obtained through a Specialty Pharmacy.
• Assist patient with foundation copay programs, if eligible for reimbursement.
• Obtain foundation copay card information once assistance approved.
• Obtain prior-authorization for infusion services from patient insurance by calling carrier or submitting forms.
• If Specialty Pharmacy utilized, submit proper paperwork and patient clinical information.
• Assist in claims payment follow-up involving denials related to authorization or insurance coverage.
• Communicate necessary patient financial information with appropriate office and billing personnel.
• Communicate with patient regarding deductibles, copays, coinsurance, and financial assistance coverage.
• Alert supervisor of roadblocks to timely verification, prior authorizations and payment of infusion claims.
• Provide quality service to patients.
• Abide by all federal, state, and payer requirements and regulations.
• Perform other duties as assigned.

Skills

Communication

Customer service

Bilingual (English/Spanish)

Medical terminology (CPT/ICD-10)

Education

High School Diploma or GED

Associate degree preferred

Tools

MS Word

MS Excel

Job description

GI Alliance is seeking an experienced Infusion Intake Specialist II to review infusion orders and verify patient benefits to secure payment for services.

You will determine buy & bill vs Specialty Pharmacy pathways, assist with foundation copay programs, and secure prior authorizations while coordinating with insurance and pharmacy partners. Experience in infusion intake is preferred.