Intake Specialist - Revenue Cycle Management

Vital Care Infusion Services•Tucson, AZ

2d•Onsite

About The Position

The Intake Specialist performs revenue cycle management duties to process referrals accurately and on time, follow established processes, and help reduce denials, days sales outstanding, and bad debt. The role identifies additional revenue opportunities and ways to improve collection rates while working within standard or accepted practices. Duties also include credentialing, re-credentialing, and contract applications. The specialist reviews patient files, verifies benefits, obtains prior authorizations, submits claims, and follows up with payers and customers. The role communicates order and authorization status, documents account activity, and escalates issues that may delay service or interrupt therapy. It also explains therapy costs and financial obligations to patients and contributes billing expertise to training, policies, and procedures for the revenue cycle management team. This is a full-time, on-site position in Meridian, with a stated salary range of $18.92–$23.46.

Requirements

High school diploma or equivalent, plus specialized training in intake, pharmacy or medical billing, and/or collections.
Two years of experience in intake, medical billing, and/or collections.
Two years of home infusion therapy experience.
Excellent English communication skills, including listening, speaking, understanding, and writing, with the ability to influence patients, caregivers, and payer representatives and advance reimbursement and collection efforts.
Understanding of processes, systems, and techniques for successful billing and collection 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 the MS Office suite and pharmacy applications.

Nice To Haves

Coding Course Certification.

Responsibilities

Review patient files for completeness and accuracy, identify and audit claims, ensure revenue opportunities are included, and submit primary and secondary billing to payers through paper bills and clearinghouse submissions.
Communicate with franchise partners and other 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, follow up with payers to provide required information, track and expedite responses, and keep customers informed.
Track, report, and escalate authorization or other service issues that delay service, to support patient access and avoid interruptions to therapy.
Explain patients’ financial obligations and therapy costs before service begins.
Contribute medical billing expertise to training and knowledge-transfer programs, materials, policies, and procedures for the RCM team.
Assist with online adjudication of collection issues and nurse billing as assigned.
Perform other related duties as assigned.