Intake Specialist

PromptCare, Inc.; New Providence (NJ); Hybrid; USD 42,000 - 66,000; Full time

Benefits offered by this job

Comprehensive Medical, Dental, and Vis

401(k) Plan with Company Match

Generous PTO: Vacation, Sick Time, and

Life Insurance

Employee Assistance Program

Disability Insurance

HR Benefits

Commuter Spending Programs

Volunteer Opportunities

Referral Bonuses

Job summary

PromptCare, Inc. seeks an experienced Intake Specialist to manage referrals from multiple sources in our service area with a focus on infusion therapies and exceptional patient service. You will verify eligibility, enter patient data, and coordinate with insurers and providers to optimize reimbursement.

Reports to Departmental Lead, Supervisor or Manager. This is a Full-Time, 40-hour per week role with hybrid work locations in New Providence, NJ or Lenexa, KS.

Qualifications

• High school diploma or GED required.
• Experience working with insurance companies and healthcare professionals preferred.
• Experience with specialty pharmacy patient admissions and patient service preferred.
• IVIg case management experience preferred.
• Strong PC skills; MS Office proficiency; familiarity with pharmacy order processing system CPR+ is a plus.

Responsibilities

• Obtain initial patient referral admission data and document it.
• Interface with external clients to obtain initial authorization.
• Notify staff of pending referrals and admissions.
• Enter new patient information into the order processing system.
• Generate and track forms until all documentation is received.
• Update patient and clinical information daily in the system.
• Verify eligibility and benefits with insurance, including pre-authorizations.
• Communicate eligibility requirements and contract provisions to clients and staff.
• Coordinate services to ensure reimbursement and appropriate levels of care.
• Collaborate with billing for re-authorizations or billing needs.

Skills

Insurance coordination

Specialty pharmacy admissions

Customer service

IVIg case management

Education

High school diploma or GED

Tools

MS Office

CPR+

Job description

Description

We are seeking an experienced Intake Specialist to join our team. The Intake Specialist is responsible for receiving and managing referrals from various referral sources in our service areas. The ideal candidate will have a strong background in infusion therapy and be able to provide exceptional customer service to our patients. If you are a detail-oriented individual with a passion for providing exceptional patient care, we encourage you to apply for this exciting opportunity.

Reports to: Departmental Lead, Supervisor or Manager

Job Type: Full-Time, 40 hours per week, Monday - Friday

Location: Hybrid, out of either New Providence, NJ or Lenexa, KS

Requirements

• High school diploma or GED
• Previous experience working with insurance companies and healthcare professionals (physicians, nurses, etc.) is preferred
• Previous experience with specialty pharmacy patient admissions and customer service in a similar referral source-based practice setting is strongly preferred
• IVIg case management experienced preferred
• Must have strong PC skills, especially the MS Office suite. Previous experience with the pharmacy order processing system, CPR+, is a major advantage (although training will be provided)

Job Responsibilities, included but not limited to:

• Obtains initial patient referral admission data and documents
• Directly interfaces with external clients and obtains initial authorization
• Notifies appropriate staff of all pending referrals and patient admissions
• Enters new patient information into the order processing system
• Generates and tracks forms (e.g., LMN, AOB, Consent for Treatment) until all pertinent documentation is received
• Consistently updates patient and clinical information in the order processing system
• Manages patients on the master log every day and forwards to appropriate staff
• Responsible for verifying eligibility and benefits through insurance companies including obtaining prior authorizations and/or pre-determinations
• Communicates in writing or via phone with clients, family members, agents, physicians and discharge planners on eligibility requirements, policy benefits, eligibility determinations and contract provisions
• Proactively researches and resolves issues impacting benefit coverage and revenue optimization
• Performs medical /pharmacy benefit verification requiring complex decision skills based on payer and process knowledge resulting in on boarding or case determined a “no go”
• Contacts benefit providers to gather policy benefits/limitations
• Coordinates and ensures services provided will be reimbursable (e.g., deductible amounts, co-payments, effective date, levels of care, authorization, etc.)
• Communicates with patients regarding Welcome and Financial call information
• Works closely with the billing department for re-authorizations or billing needs, etc.
• Other duties assigned

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk and listen. The employee is required to occasionally walk, and bend or stand as necessary. This position requires the ability to occasionally open filing cabinets, lift office products and supplies of 25 pounds but no more than 50 pounds.

Benefits & Perks

• Comprehensive Medical, Dental, and Vision Package
• 401(k) Plan with Company Match
• Generous PTO: Vacation, Sick Time, Personal Days, and Paid Holidays
• Life Insurance: Standard coverage with optional enhancements
• Employee Assistance Program: Free counseling and coaching sessions
• Emotional Well-being and Work-Life Balance Resources
• Short & Long-Term Disability: Company-paid with optional supplements
• Accidental Death and Dismemberment Insurance
• FSA and HSA: Manage healthcare expenses
• Commuter Spending Programs
• Volunteer and Engagement Opportunities
• Employee Referral Bonuses
• Exclusive Discounts on entertainment, travel, and various other supplemental and cellphone plans

Equal Employment Opportunity

The PromptCare Companies is committed to Equal Employment Opportunity (EEO) and prohibits employment discrimination on the basis of race, color, age, national origin, religion, gender, gender identity, sexual orientation, pregnancy, marital status, genetic disposition, disability, veteran's status or any other characteristic or classification protected by State/Federal/Local laws. We foster a work environment in which diversity and inclusion are embraced, people are hired and advanced on their merits, and employees are treated with mutual respect and dignity.