Intake Coordinator

Lincare • Texarkana, TX

112d

About The Position

The Intake Coordinator acts as a liaison between the referral source and the Pharmacy to ensure a seamless transition from the acute care setting to home care for our patients. This role involves establishing and maintaining relationships with referral sources, processing intake information for potential patients who require home infusion therapy, and facilitating the intake process by procuring all necessary patient information. The Intake Coordinator is responsible for verifying health insurance coverage, obtaining authorization numbers, and performing case management updates. Additionally, the coordinator notifies referral sources of acceptance or denial of referrals and coordinates discharge plans when necessary. The position also includes negotiating pricing, maintaining Medicare CMNs, and managing billing documentation.

Requirements

• High school diploma or equivalent
• 2-5 years of medical terminology, insurance verification, and/or medical services experience required
• 1-2 years of experience with home infusion preferred
• Experience with ICD-9 coding preferred
• College degree is desirable
• 2-3 years experience with home care, discharge planning, or insurance billing a plus
• Maintain a current insurable driver's license

Responsibilities

• Establishes and maintains relationships with referral sources by receiving and processing intake information for potential patients who require home infusion therapy
• Facilitates intake process by procuring all patient information necessary to determine home infusion admission based on supportive clinical data, prescribed therapy, assignment of home infusion benefits, and following all patient acceptance criteria policies and procedures
• Identifies participating payers and contractual pricing agreements
• Verifies health insurance coverage using verification forms
• Inquires about case management, with authorization number and pre-certification
• Obtains/maintains authorization numbers
• Performs case management updates for changes in therapy and patient status
• Contacts referral source to notify of acceptance or denial of referral once verification is complete and admission criteria is reviewed/approved by clinical staff
• Coordinates the discharge plan with the referral source/discharge planner, nursing agency when applicable, pharmacy, and patient/caregiver
• Establishes relationships with licensed and certified nursing agencies to provide clinical nursing services to pharmacy patients
• Notifies patient or approved patient advocate and explains their financial responsibilities
• Completes all applicable sections of Intake and Confirmation forms, and enters into CPR+
• Negotiates pricing with case management under the direct supervision of Center Manager
• Assists with the creation and maintenance of Medicare CMNs
• Obtains and tracks authorizations
• Completes monthly re-verification of Medicaid recipients
• Documents credit and cash co-payments made at location level
• Obtains clinical documentation necessary for billing
• Responsible for the intake of personal referrals
• Data-entry and updating patients' demographic information
• Insurance benefit verification and coordination with nursing and pharmacy staff
• Prepares and manages paperwork and documentation for billing and collections
• Resolves patient/payee issues in a timely manner

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees