Intake Specialist

Peoples Health Services LLC; Pensacola (FL); Vor Ort; USD 35.000 - 45.000; Vollzeit

Zusammenfassung

Peoples Health Services LLC in Pensacola, FL is seeking an Intake Specialist to manage admission information, verify benefits, and relay clinical details to obtain home care authorizations. You will handle referrals, assess coverage, and enter data into the system with accuracy and confidentiality.

The role requires strong organizational skills, experience in medical billing or insurance, and proficiency with Word and Excel.

Qualifikationen

• Associates degree preferred; High School Graduate required.
• Minimum three years in a medical field or medical office setting preferred.
• Knowledge of billing, insurance reimbursement, medical terminology, and diagnosis coding preferred.
• Experience troubleshooting computer errors, maintaining records and organizing preferred.
• Proficiency using Microsoft Word and Excel required.
• Ability to prioritize, manage time effectively and make independent decisions.

Aufgaben

• Accurately enters all demographic, financial and referral data for billing and scheduling.
• Answer phones and appropriately route referral calls based on clinical needs.
• Prioritize phone follow-up with doctors and insurance companies.
• Back up Intake Supervisor by preparing referrals for clinical review according to policy.
• Prioritize referrals to meet urgent needs; coordinate with CTMs, schedulers and sources.
• Assist in calculating co-pays and deductible amounts per insurance rates.
• Complete initial authorization documentation per insurance contracts.
• Notify staff of authorizations and visit limits; discharge decision if denial occurs.
• Collaborate with insurance carriers for benefits and eligibility.
• Coordinate with CTM/Case Manager for authorized visits and patient needs.
• Follow up with AE/Liaisons to confirm referrals and needed documentation.
• Answer after-hours inquiries and assist with copying, faxing, etc.
• Maintain a professional image and patient confidentiality at all times.

Kenntnisse

Customer service

Phone etiquette

Data entry

Insurance terminology

Billing knowledge

Prioritization

Ausbildung

High School Graduate

Associates degree preferred

Tools

Microsoft Word

Excel

Jobbeschreibung

Description

Peoples Health Services is the only family-owned, locally governed Hospice and Home Health provider in the Florida Panhandle. We believe that when we take care of the people who care for our patients, everyone benefits. We offer competitive pay, medical, dental, vision, group life, short-term disability benefits, a PTO program, 6 paid holidays, recognition programs, and work-life balance initiatives including a Relax & Recharge Day annually. Join a team that is dedicated to caring for our community—and each other.

Position Summary:

Is responsible for distributing admission information according to company policy; prioritizing phone calls; ensuring admission packets are available and appropriate; and interpreting insurance policy benefits to accurately reflect coverage amounts and Client co-pay (prior approval of insurance authorization). The Intake Specialist must be able to discuss and relay appropriate clinical information to obtain authorization for Home Care Services. They are also responsible for accurate data entry of referral data into HCMS. Abide by and demonstrates the company Mission, Vision, and Guiding Principles through both behavior and job performance on a day-to-day basis.

Essential Duties & Responsibilities:

• Accurately enters all demographic, financial and referral data in to the computer systems to facilitate billing and scheduling in a timely manner.
• Answer phones and appropriately routes referral calls. Routes calls based on clinical needs.
• Prioritizes phone call for follow up (i.e. doctors, insurance company)
• Back up to Intake Supervisor by preparing the client referral for clinical in accordance with company policy, state and federal guidelines and private insurance contracts.
• Appropriately prioritizes referrals so that the most urgent needs are met first. This includes consulting with CTM’s, schedulers, and referral sources for coordination of admission dates ad times.
• Calculates co-pays and deductible amounts as per insurance reimbursement rates.
• Completes all necessary documentation for initial authorization in accordance with the insurance company contracts.
• Completes all request for all follow up authorization as needed, notifies staff of all authorizations received and visit limits as well as need to discharge client due to denial for further authorization.
• Participates in communications and resolution of problems with insurance interpretation. Identifies insurance carriers and verifies benefits and eligibility.
• Collaborates with CTM/Case Manager on authorized visit to assure accurate utilization for patient needs.
• Follow up with AE/Liaisons via text or email to assure notification of referrals received and documentation needed.
• Answer text or calls on weekends and after hours for insurance questions of new referrals.
• Acts as backup to clinical staff and assist as necessary with copying, faxing, etc.
• Demonstrates the ability to make customers feel satisfied and appreciated.
• Maintains an understanding of the company’s scope of services.
• Understands the infrastructure and how and where to transfer calls in the company.
• Maintains a professional image.
• Uses appropriate phone etiquette.
• Promotes a customer friendly atmosphere for all visitors and ensures patient confidentiality at all times.
• Participates in accreditation program.
• Assist referral sources with finding placement for patient that company cannot accept due to insurance reasons.
• Passes on all outstanding referrals and details to the night time/ weekend intake supervisor, via phone/ email.
• Maintains daily referral report and sends out to assigned staff.
• Performs other duties as assigned.

Working Conditions:

Office Environment. May be exposed to biological hazards.

Requirements

Education/Experience:

• Associates degree preferred,
• High School Graduate (or equivalent) required.
• Minimum three (3) years of prior experience in a medical field or medical office setting is preferred.
• Knowledge of billing, insurance reimbursement, medical terminology, diagnosis coding preferred.
• Experience with trouble shooting computer errors, maintaining records, and organizing is preferred.
• Proficiency using Microsoft Word, and Excel is required.
• Able to prioritize and manage time effectively and make independent decisions when necessary.