Intake Manager - IG Therapy

InfuCare Rx®; United States; On-site; USD 60,000 - 90,000; Full time

Job summary

InfuCare Rx is seeking an IG Therapy Intake Manager to oversee intake, verify benefits, obtain authorizations, and provide patient financial counseling. You will collaborate with Caregivers, physicians, and internal teams to ensure accurate and timely processing, while maintaining HIPAA compliance and company policies.

The role requires experience with infusion insurance coverage, prior authorizations, and infusion pharmacy software, along with strong communication and organizational skills to

Qualifications

• Experience handling insurance coverage for infusion and familiarity with prior authorization and certificates of medical necessity.
• Ability to identify guidelines and coverage rules for approvals.
• Experience with infusion pharmacy management software.
• Strong record-keeping and data entry skills.
• Excellent communication with patients, physicians and insurers.
• Experience following up on prior authorizations with reporting.

Responsibilities

• Oversee all intake phases for IG Therapy, including benefits verification, authorization, and patient financial counseling.
• Coordinate with Caregivers, Physicians, and stakeholders to execute intake tasks.
• Obtain prior authorizations and COOs as needed; ensure accurate documentation.

Skills

Insurance coverage experience

Prior authorization

Pharmacy management software

Record keeping

Communication with patients

HIPAA compliance

Education

High school diploma (college preferred)

Tools

Excel

Internet

Word processing

Job description

Job Description

The IG Therapy Intake Manager will manage/oversee all phases of intake for the company’s IG therapy Business Unit to include benefits verification, authorization, and patient financial counseling while coordinating needed interaction with Caregivers, Physicians, and other internal/external stakeholders during the execution of these functions. This person will collaborate with the healthcare team to provide exceptional value to our customers. The IG Therapy Intake Manager will perform all duties in accordance with company policy/procedure, state professional standards, and other applicable regulatory requirements.

Principal Roles And Responsibilities

• Must be experienced with insurance coverage for infusion, specific health plans, and have familiarity with key requirements necessary for accurate benefit checks and authorizations.
• Able to accurately identify guidelines, coverage rules, and obtain prior authorization as well as certificates of medical necessity when needed.
• Have experience with Pharmacy management software for infusion
• Ability to maintain accurate and complete records.
• Communicates and resolves problems with patients/customers, physicians’ offices, referral sources, third party insurance companies, Medicaid, and Medicare.
• Proven track record and ability to work with reporting to follow up on prior authorizations.
• Ability to assess what is needed and work effectively with all members of the Infusion Team including Sales, Pharmacists, Nurses, IV Pharmacy Technician, and Drivers to accomplish goal.
• Team player willing to assist with office duties like filing, putting together charts and other duties as assigned.
• Assists with answering and directing phone calls, processing/triaging faxes and/or e-scripts to ensure timely order entry and coordination of care as part of the Intake process.
• Ability to work effectively with revenue team to maximize billing and collection of insurance claim receivables.
• Desire to educate themselves on the scope of services that are available through company and understand basic drug terminology and therapies/services provided.
• Actively support company mission, organizational/departmental policies and procedures
• Presents a professional appearance and approach w/members and other employees; demonstrates honest and ethical behavior. Handles member and employee info w/appropriate sensitivity and safeguards to ensure confidentiality and right to privacy, in compliance w/HIPAA regulatory requirements
• Contributes to the effectiveness of the team by maximizing talent through effective leadership as well as supporting, promoting and applying the best practice standards within their scope of authority
• Facilitate constructive work environment of attendance, punctuality, on time delivery, mutual respect and support while honoring diversity, effective communication, and improving the workspace
• Adjust work distribution to meet service, delivery, and companywide goals
• Take initiative to identify, develop & adapt new policies and practices to improve quality of work
• Responsible for staffing team – creating job descriptions, screening, interviewing, and selecting candidates
• Coach, mentor, and train new employees
• Responsible for providing guidance to the team members, completing yearly performance reviews, delegating responsibilities, and designating assignments
• Performs other related duties as assigned by management

Confidentiality and Compliance

• Always maintain confidentiality of patient and proprietary information
• Observe legal and ethical guidelines for safeguarding the confidentiality of patient and proprietary company information
• Understand and comply with HIPAA
• For all activities complies with accreditation, legal, regulatory, government and safety requirements

Minimum Education, Certification And Experience/Skill Requirements

• High School diploma or equivalent. College degree is preferred.
• Minimum of (5) years’ experience as an Intake Authorization Coordinator or equivalent experience relevant to position as determined by management
• Excellent Communication skills including reading, writing, and speaking to effectively handle position responsibilities
• Experience providing customer service to internal and external customers, including meeting quality standards for services, and evaluation of customer satisfaction
• Computer skills and knowledge of how to enter and access data. Knowledge of Excel, Internet and Word Processing.
• Understand how to calculate and check for correct doses of medication.
• Ability to calculate figures and amounts such as discounts, interest, and percentages.
• Must demonstrate strong attention to detail.
• Possess ability to prioritize, perform multiple tasks at one time, and have good organizational skills.
• Work under stress effectively
• Effective management skills and expertise in their skill set

Highly Preferred Certification And Experience/Skill Requirements

• Experience working in an acute or specialty infusion pharmacy
• Experience working in a hospital infusion pharmacy
• Experience with sterile compounding
• Experience with CPR+ Pharmacy Management System

Physical Demands

Required to stand, walk, sit, talk and hear; required to use hands to operate vehicles and office equipment; must be able to occasionally lift and/or move up to 25 lbs; specific vision requirements for this job include: close, distance and peripheral vision, and the ability to adjust focus, reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position without compromising patient care.

InfuCare Rx is an equal opportunity employer. All employment decisions are made without regard to race, color, religion, national origin, military status, marital status, citizenship/immigration status, sex (including pregnancy and relation conditions, sexual orientation, or gender identity), age (40 and older), disability, genetic information (including employer requests for, or purchase use, or disclosure of genetic tests, genetic services, or family medical history), retaliation for filing a charge, reasonably opposing discrimination, or participating in a discrimination lawsuit, investigation, or proceeding. Background checks and drug screens are part of our hiring process. Affimative Action/Equal Opportunity Employer, Minority/Female/Disabled/Veteran.