Infusion Benefits Coordinator I

ARTHRITIS & RHEUMATISM ASSOCIATES P•Friendship Heights Village, MD

5d•$25 - $25•Onsite

About The Position

Join us at Arthritis and Rheumatism Associates! We are a dynamic and creative team who are leading the way in healthcare innovation as we set the standard on optimum patient care. We offer competitive pay and excellent work-life balance with our 4-day work week (closed Fridays).

Requirements

At least two years of experience working in physicians’ office and/or infusion center.
Knowledge of HIPAA.
Must possess good interpersonal and communication skills to facilitate interaction with staff, patients and business contacts.
Must possess a professional and responsible attitude.
Knowledge of infusion billing practices.
Knowledge of infusion medical coding.
Knowledge of insurance infusion billing practices.
Skill with computer applications and use of calculator.
Ability to communicate clearly and effectively with staff, patients, practice business associates, physicians, and others.
Ability to effectively communicate in writing.

Nice To Haves

Experience dealing with insurance companies and billing are preferred.
AA or BS degree preferred.

Responsibilities

Interaction with practice business associates, physicians and patients as required.
Investigate and coordinate all patient infusion benefits and options.
Verify that infusion orders, referrals, and/or prior authorizations are obtained prior to infusion treatments.
Calculate patient financial responsibility estimates for infusion services that will be administered.
Counsel patients on the findings from our benefit investigations.
Assist patients with enrollment to copay assistance programs.
Update and verify new insurances when required.
Schedule all initial infusion appointments and set appointment alerts for check-in/out staff.
Schedule follow-up infusions, office visits, labs, and DEXA’s when necessary.
Stay up to date on all infusion drugs used and the respective pharmaceutical companies and their assistance programs.
Stay up to date on all accepted insurances.
Review and accepts order assignments in ReferralMD.
Update order statuses in ReferralMD and document any needed conversations or events.
Verify that the drug ordered in EHR is the same drug that is preauthorized, in the OOP alert, and in the appointment book.
Call insurance carriers for eligibility and benefit verification.
Submit for prior authorization or predetermination to payers when needed.
Enter authorizations under the insurance in EPM and create authorization alerts in the patient chart.
Place yearly alerts with benefits information obtained in the investigation.
Assist patients with their enrollment to assistance programs.
Schedule/Cancel/Reschedule infusion, doctors, labs, and DEXA appointments in NextGen EPM.
Review scheduled appointments and create out-of-pocket alerts and counsel patients when needed.
When creating OOPs, review and counsel the patient any financial balances and include them in the amount to be collected.
Document all information on Pre-Infusion log and scan completed paperwork to the patient’s chart.
Use the Pre-Infusion Checklist to also generate BI log documents in EHR.
Email physicians to provide updates on any delays with scheduling.
Assist Business Office with: Following up on infusion appeals, Accounts for indigent infusion patients, Infusion billing errors, Billing inquiries.
Become familiar and utilize ICD-10 and CPT coding to maximize infusion functions and assist the reimbursement processes.
Arrange the delivery for free and specialty pharmacy drugs when needed.
Assist with incoming phone calls to the Arise mainline when possible.
Handle infusion problem accounts and/or patients to resolution.
Participate in educational activities.
Follows compliance requirements mandated by CMS, Medicare and all other ARA contracted carriers.
Knowledge of financial and coding practices necessary to ensure the accurate submission of infusion charges for services rendered in accordance with all federal, state, and local regulations.
Follows guidelines for maintaining patient confidentiality.
Demonstrates a strong commitment to honest and responsible corporate conduct.
Identifies reports and/or prevents any fraudulent or unethical behavior.
Initiates notification to management if inappropriate behavior is observed within the organization.
The responsibilities associated with this position allow access to the computer “role” of Infusion only.
For this employee to carry out his/her job (carry out TPO) in a manner that best serves our patients, the employee needs access the afore mentioned computer “role”.
Access to computer information is password protected.
Upon termination of an employee, his/her password will be deleted from the system.

Benefits

Health/Dental/Vision Insurance
FSA
HSA
Life Insurance
401K Contributions
Disability Insurance
Paid Time Off
Tuition Assistance
Paid Maternity and Paternity Leave
STD/LTD/ADD Insurance (short-term disability, long-term disability and accidental death and dismemberment insurance)