Intake Specialist

Vital Care Infusion Services•Monroeville, PA

11d•Onsite

About The Position

The Intake Specialist processes referrals with an emphasis on accuracy, timeliness, and adherence to established processes to reduce denials, days sales outstanding, and bad debt. The role identifies additional revenue opportunities, improves collection rates within accepted practice limits, and handles credentialing, re-credentialing, and contract applications. This position is full-time and on-site in Meridian.

Requirements

High school diploma or equivalent, plus specialized training in intake, pharmacy or medical billing, and/or collections.
Two years of intake, medical billing, and/or collections experience.
Two years of home infusion therapy experience.
Excellent English listening, speaking, comprehension, and writing skills, including the ability to communicate with and influence patients, caregivers, and payer representatives.
Understanding of processes, systems, and techniques for successful billing and collections across payer types.
Ability to identify documentation gaps and problems, determine lasting solutions, make effective decisions, and take corrective action.
Strong organizational skills and ability to maintain clear, complete records of activities, cases, and related documentation.
Knowledge and skill in using Microsoft Office software and pharmacy applications.

Nice To Haves

Coding course certification is highly preferred.

Responsibilities

Review patient files for completeness and accuracy; identify and audit claims; ensure all revenue opportunities are included; and submit primary and secondary billing to payers for reimbursement through paper bills and clearinghouse submissions.
Communicate with franchise partners and other VCI departments about order intake status.
Document case activity, communications, correspondence, and actions taken to resolve outstanding claims issues in the computer system.
Schedule follow-ups at required intervals.
Investigate and verify benefits for pharmacy and medical third-party claims.
Obtain prior authorizations by initiating requests, following up with additional required information, tracking progress, expediting payer responses, and keeping customers informed.
Track, report, and escalate authorization-related service issues and other issues that delay service, to support patient access and avoid interruptions to therapy.
Explain patients’ financial obligations so they understand therapy costs before service begins.
Contribute medical billing expertise to training and knowledge-transfer programs, materials, policies, and procedures to improve the RCM team's efficiency and effectiveness.
Assist with online adjudication of collection issues and nurse billing as assigned.
Perform other related duties as assigned.