Intake/Reimbursement Specialist

Fairview Health Services•Shoreview, MN

About The Position

As a member of the pharmacy team, the Reimbursement Specialist uses strong customer service skills and knowledge of authorization and reimbursement practices to ensure patients fast, easy and appropriate access to pharmacy services. The Reimbursement Specialist accepts and processes referrals, identifies payer sources, verifies benefit information and acquires initial authorization as needed to begin patient service or to determine denial of patient service. This position also follows up on pending unresolved coverage issues and claim denials and documents and communicates to appropriate providers and internal department's accurate authorization information on current or potential patients. This position may also complete the patient intake process, schedule patient appointments and partner with care team and external resources to ensure efficient patient flow as assigned.

Requirements

2 years experience in a pharmacy setting or with revenue cycle, health insurance or benefit experience using an enterprise software system in healthcare or insurance organization

Nice To Haves

Bachelor of Science in business, communications, health care or related field.
2 years revenue cycle, health insurance or benefits experience using an enterprise software system in the assigned clinical area or service line of a complex healthcare organization.
Knowledge of ICD9 and ICD10 coding.

Responsibilities

Perform verification of insurance benefits, analysis and identify any potential coverage issues
Assure fast, easy access to pharmacy services while documenting accurate referral and reimbursement (payer) information, coordinating the intake and benefit authorization process
Assist in resolving problems with payers and provide information and expertise to other departments.
Partner with potential international and self-pay patients on any financial or service needs related to their care as assigned.