Intake Quality and Process Auditor

Hirebridge; Phoenix (AZ); Remote; USD 45,000 - 75,000; Full time

Job summary

An established industry player in home infusion therapy is seeking a dedicated Intake Coordinator to enhance patient access to vital medications. This full-time remote role involves verifying insurance eligibility, conducting audits, and ensuring compliance with regulations. The ideal candidate will possess strong communication and analytical skills, along with a keen attention to detail. Join a dynamic team committed to improving patient care and enjoy a culture that values innovation and teamwork. This opportunity not only offers professional growth but also provides a comprehensive benefits package, including health and dental insurance, retirement plans, and the flexibility of remote work.

Benefits

Health Insurance

Vision Insurance

Dental Insurance

Long Term Disability Insurance

Life Insurance

401K Plan with Employer Match

Vacation Package

Remote Work Opportunity

Qualifications

• Minimum 3 years of experience in intake or insurance verification required.
• Strong knowledge of home infusion services and payer guidelines.

Responsibilities

• Conduct audits of patient referrals and insurance verifications.
• Train new hires on intake processes and compliance.
• Collaborate with teams to ensure proper documentation for claims.

Skills

Insurance Verification

Communication Skills

Attention to Detail

Analytical Skills

Time Management

Problem Solving

Education

High School Diploma or GED

Tools

Electronic Medical Records (EMR)

Intake Management Systems

Microsoft Office

Job description

Experience within Home Infusion Immunoglobulin Therapies

Remote Position

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!

JOB SUMMARY:
The Quality and Process Auditor is responsible for reviewing each case to ensure all required metrics are accurately completed to support reimbursement. This role involves auditing intake procedures, identifying areas for improvement, and implementing quality control measures to enhance accuracy and efficiency. The auditor collaborates with the Intake team, other departments, and leadership to uphold the highest standards in documentation and compliance. Additionally, the Quality and Process Auditor provides training as needed on intake processes, policies, and procedures to ensure consistency and adherence to best practices.

EXPERIENCE:
High school diploma or general education degree (GED) equivalent is required.
Previous role in management and/or Minimum of 3 years of experience in intake, insurance verification, authorization, or similar vocations, preferably in the home infusion field required.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

1. Conduct regular audits of patient referrals, insurance verifications, and authorizations to identify errors and discrepancies.
2. Audits Intake team, providing guidance and training.
3. Develop and implement audit processes to ensure accuracy and completeness in patient intake documentation.
4. Monitor compliance with payer requirements, state and federal regulations, and company policies.
5. Work closely with intake coordinators to address and resolve any identified issues in documentation and processes.
6. Assist with training new hires and existing employees on intake processes, compliance, and best practices.
7. Collaborate with billing and reimbursement teams to ensure proper documentation for claims processing.
8. Assist in developing and updating standard operating procedures (SOPs) for intake auditing.
9. Generate reports on audit findings and recommend corrective actions to management.
10. Participate in process improvement initiatives to enhance the efficiency of the intake department.
11. Serve as a resource for Intake team members regarding complex cases and payer-specific requirements.
12. Ensure timely follow-up on audit findings and corrective actions.
13. Responsible for adhering to the quality, production, and turnaround standards associated with the department and/or assigned program.
14. Trains new and existing associates in the use of pharmacy software system, supplemental applications, job responsibilities, and departmental workflow.
15. Identifies deviations from training and/or processes during normal work activity.
16. Responds to patient inquiries, requests and issues when situations get escalated to a higher level of authority.
17. Establishes, maintains and promotes strong professional relationships with internal and external parties.
18. Communicates and collaborates with other departments, including nursing, pharmacy and sales.
19. Participates 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.
20. Complies with and adheres to all regulatory compliance areas, policies and procedures and company best practices.
21. Serves as the back-up and support of the manager as needed.
22. Make suggestions and recommendations to management in an effort to continually improve the operation.
23. Interact with others in a positive, respectful, and considerate manner.
24. Performs other job-related duties as assigned.

QUALIFICATION REQUIREMENTS:

1. Prior experience in a supervisory or leadership role is preferred.
2. Strong knowledge of home infusion services, insurance verification, and payer guidelines. Familiarity with Medicare, Medicaid, and commercial insurance policies.
3. Excellent attention to detail and analytical skills. Strong communication and interpersonal skills. Ability to train and mentor staff effectively.
4. Proficiency in using electronic medical records (EMR) and intake management systems. Ability to work collaboratively across departments to ensure compliance and process efficiency.
5. Approachable and dedicated to providing the highest quality of service.
6. Ability to communicate effectively and professionally with patients, physicians, and coworkers. Ability to make decisions, solve problems, and work independently with little supervision.
7. Demonstrate active listening and understanding skills.
8. Ability to prioritize and meet deadlines.
9. Ability to adapt to change quickly.
10. Strong work ethic with personal qualities of integrity and credibility.
11. Excellent oral and written communication, interpersonal, organizational and management skills.
12. Proficient in the use of Microsoft Office products.

Steps to Apply:

To apply for this role, you must complete a Culture Index Assessment to be considered. Please note that your application will not be considered if the Assessment is not completed.

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.